Individual
MRS. SANDRA L JAMISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC SLP
Contact information
Practice address
1327 KALAKAKET ST, FAIRBANKS, AK 99709-4917
(907) 452-4517
(907) 452-4263
Mailing address
3801 SPINACH CREEK RD, FAIRBANKS, AK 99709
(907) 455-9033
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
12
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A003
TRICARE
—
Enumeration date
03/03/2006
Last updated
07/08/2007
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