Provider Demographics
NPI:1720785082
Name:PAMPUSH, JAYMIE
Entity Type:Individual
Prefix:
First Name:JAYMIE
Middle Name:
Last Name:PAMPUSH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2737 TONAWANDA DR
Mailing Address - Street 2:
Mailing Address - City:ROCKY RIVER
Mailing Address - State:OH
Mailing Address - Zip Code:44116-3032
Mailing Address - Country:US
Mailing Address - Phone:440-665-4002
Mailing Address - Fax:
Practice Address - Street 1:2737 TONAWANDA DR
Practice Address - Street 2:
Practice Address - City:ROCKY RIVER
Practice Address - State:OH
Practice Address - Zip Code:44116-3032
Practice Address - Country:US
Practice Address - Phone:440-665-4002
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-07
Last Update Date:2023-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist