Provider Demographics
NPI:1770811630
Name:HARPER, JAIME LYN (MS,CCC-SLP)
Entity type:Individual
Prefix:
First Name:JAIME
Middle Name:LYN
Last Name:HARPER
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 1:5055 HIGHWAY 26
Mailing Address - Street 2:
Mailing Address - City:DERIDDER
Mailing Address - State:LA
Mailing Address - Zip Code:70634-7337
Mailing Address - Country:US
Mailing Address - Phone:337-396-5850
Mailing Address - Fax:
Practice Address - Street 1:5055 HIGHWAY 26
Practice Address - Street 2:
Practice Address - City:DERIDDER
Practice Address - State:LA
Practice Address - Zip Code:70634-7337
Practice Address - Country:US
Practice Address - Phone:337-396-5850
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-03
Last Update Date:2015-06-09
Deactivation Date:2015-05-27
Deactivation Code:
Reactivation Date:2015-06-09
Provider Licenses
StateLicense IDTaxonomies
LA5930235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist