Provider Demographics
NPI:1255096327
Name:HINSON-FUSHILLE, JAMIE LEE (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:LEE
Last Name:HINSON-FUSHILLE
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:MRS
Other - First Name:JAMIE
Other - Middle Name:LEE
Other - Last Name:HINSON-FUSHILLE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:412 STONEBLUFF RD
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-3311
Mailing Address - Country:US
Mailing Address - Phone:915-892-5672
Mailing Address - Fax:
Practice Address - Street 1:5430 BUCKLEY DR
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912-6421
Practice Address - Country:US
Practice Address - Phone:915-230-2876
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-03
Last Update Date:2021-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19394235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist