Provider Demographics
NPI:1548434426
Name:ARCHER, JAMY CLAIRE (MS CCC SLP, LSLS AVT)
Entity type:Individual
Prefix:
First Name:JAMY CLAIRE
Middle Name:
Last Name:ARCHER
Suffix:
Gender:F
Credentials:MS CCC SLP, LSLS AVT
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Mailing Address - Street 1:1705 COLLEGE ST STE 220
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29201-3917
Mailing Address - Country:US
Mailing Address - Phone:803-777-2630
Mailing Address - Fax:803-777-3081
Practice Address - Street 1:1705 COLLEGE ST STE 220
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29201-3917
Practice Address - Country:US
Practice Address - Phone:803-777-2630
Practice Address - Fax:803-777-3081
Is Sole Proprietor?:No
Enumeration Date:2008-04-22
Last Update Date:2024-05-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI2868154235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC426521Medicaid