Individual
JAIME L CARMODY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.,CCC-A
Contact information
Practice address
12380 OLIVE BLVD, CREVE COEUR, MO 63141-6443
(314) 729-0077
(314) 729-0101
Mailing address
1010 OLD DES PERES RD, SAINT LOUIS, MO 63131-1865
(314) 722-2957
(314) 729-0101
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
2006006300
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
138830003
MEDICARE PTAN
MO
Enumeration date
04/01/2008
Last updated
02/25/2019
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