Provider Demographics
NPI:1144738907
Name:JABLONSKI, JAIMIE MARIE (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:JAIMIE
Middle Name:MARIE
Last Name:JABLONSKI
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1410 VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:WALL TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:07719-4059
Mailing Address - Country:US
Mailing Address - Phone:732-492-1363
Mailing Address - Fax:
Practice Address - Street 1:1314 MAIN ST
Practice Address - Street 2:
Practice Address - City:BELMAR
Practice Address - State:NJ
Practice Address - Zip Code:07719-2715
Practice Address - Country:US
Practice Address - Phone:848-404-9395
Practice Address - Fax:848-404-9396
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-15
Last Update Date:2024-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00864400235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist