Provider Demographics
NPI:1780238485
Name:ROSSITER, JAYNIE ELAINE (MA, CCC-SLP)
Entity type:Individual
Prefix:
First Name:JAYNIE
Middle Name:ELAINE
Last Name:ROSSITER
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 1:1688 ROUTE 426
Mailing Address - Street 2:
Mailing Address - City:CLYMER
Mailing Address - State:NY
Mailing Address - Zip Code:14724-9645
Mailing Address - Country:US
Mailing Address - Phone:814-462-0784
Mailing Address - Fax:
Practice Address - Street 1:201 STATE ST
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16550-0002
Practice Address - Country:US
Practice Address - Phone:814-877-3108
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-31
Last Update Date:2019-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL014607235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist