Provider Demographics
NPI:1669782728
Name:CHEVALIER, JAMIE ANN (AUD)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:ANN
Last Name:CHEVALIER
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:JAMIE
Other - Middle Name:ANN
Other - Last Name:MCCUIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:111 COLCHESTER AVE
Mailing Address - Street 2:WP4 - ACC
Mailing Address - City:BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05401-1473
Mailing Address - Country:US
Mailing Address - Phone:802-847-4535
Mailing Address - Fax:802-847-8198
Practice Address - Street 1:111 COLCHESTER AVE
Practice Address - Street 2:WP4 - ACC
Practice Address - City:BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05401-1473
Practice Address - Country:US
Practice Address - Phone:802-847-4535
Practice Address - Fax:802-847-8198
Is Sole Proprietor?:No
Enumeration Date:2010-10-07
Last Update Date:2010-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT8046504231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist