Provider Demographics
NPI:1265885800
Name:BECK, JAMIE MARIE (MA CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:JAMIE
Middle Name:MARIE
Last Name:BECK
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 STATE ST STE 6
Mailing Address - Street 2:
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04401-5343
Mailing Address - Country:US
Mailing Address - Phone:207-843-5740
Mailing Address - Fax:
Practice Address - Street 1:109 STATE ST STE 6
Practice Address - Street 2:
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-5343
Practice Address - Country:US
Practice Address - Phone:207-843-5740
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-19
Last Update Date:2022-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI7101003954235Z00000X
GASLP008686235Z00000X
MESP2471235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist