Individual
JAMIE SELVIDIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
100 CUMMINGS CTR, SUITE 135H, BEVERLY, MA 01915-6115
(978) 927-0172
(978) 927-0179
Mailing address
100 CUMMINGS CTR, SUITE 135H, BEVERLY, MA 01915-6115
(978) 927-0172
(978) 927-0179
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
7149
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12127595
ASHA
MA
01
—
7149
MASS. STATE LICENSE
MA
Enumeration date
08/09/2007
Last updated
08/09/2007
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