Provider Demographics
NPI:1265732523
Name:JARAMILLO, NATALIE (MS CCC/SLP)
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:
Last Name:JARAMILLO
Suffix:
Gender:F
Credentials:MS CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:52 RAILSTONE DR
Mailing Address - Street 2:
Mailing Address - City:SOUTHBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06488-2459
Mailing Address - Country:US
Mailing Address - Phone:203-262-3302
Mailing Address - Fax:
Practice Address - Street 1:21 ELM ST
Practice Address - Street 2:
Practice Address - City:NEW MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06776-2915
Practice Address - Country:US
Practice Address - Phone:860-350-7292
Practice Address - Fax:860-210-7400
Is Sole Proprietor?:No
Enumeration Date:2010-11-02
Last Update Date:2010-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT003878235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist