Provider Demographics
NPI:1053548578
Name:WELLS, JAYME LYNN (MA, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:JAYME
Middle Name:LYNN
Last Name:WELLS
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:JAYME
Other - Middle Name:LYNN
Other - Last Name:THOMPSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:410 S TEJON AVE
Mailing Address - Street 2:
Mailing Address - City:PUEBLO WEST
Mailing Address - State:CO
Mailing Address - Zip Code:81007-2230
Mailing Address - Country:US
Mailing Address - Phone:719-334-9675
Mailing Address - Fax:
Practice Address - Street 1:410 S TEJON AVE
Practice Address - Street 2:
Practice Address - City:PUEBLO WEST
Practice Address - State:CO
Practice Address - Zip Code:81007-2230
Practice Address - Country:US
Practice Address - Phone:719-334-9675
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-11
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO12054566235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist