Provider Demographics
NPI:1144548868
Name:MOBED, JAMIE LYNN
Entity type:Individual
Prefix:MRS
First Name:JAMIE
Middle Name:LYNN
Last Name:MOBED
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:JAMIE
Other - Middle Name:LYNN
Other - Last Name:RUMPF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:134 SUMMER ST
Mailing Address - Street 2:UNIT 2
Mailing Address - City:WATERTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02472-3803
Mailing Address - Country:US
Mailing Address - Phone:845-820-2442
Mailing Address - Fax:
Practice Address - Street 1:484 MAIN ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01608-1893
Practice Address - Country:US
Practice Address - Phone:508-757-2756
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-05
Last Update Date:2010-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7671235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist