Provider Demographics
NPI:1952619405
Name:FAITLOWICZ, JAIME LAUREN (MS)
Entity Type:Individual
Prefix:MS
First Name:JAIME
Middle Name:LAUREN
Last Name:FAITLOWICZ
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:99 SE MIZNER BLVD
Mailing Address - Street 2:# 425
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33432-5022
Mailing Address - Country:US
Mailing Address - Phone:516-359-6325
Mailing Address - Fax:
Practice Address - Street 1:900 N FEDERAL HWY
Practice Address - Street 2:SUITE 220
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33432-2755
Practice Address - Country:US
Practice Address - Phone:561-994-6590
Practice Address - Fax:561-994-6690
Is Sole Proprietor?:No
Enumeration Date:2010-09-17
Last Update Date:2010-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSZ5178235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist