Provider Demographics
NPI:1043463052
Name:LAFFERTY, JAIME (MS CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:JAIME
Middle Name:
Last Name:LAFFERTY
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:JAIME
Other - Middle Name:
Other - Last Name:FERRO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SLP
Mailing Address - Street 1:9 MOUNT PLEASANT TPKE STE 102
Mailing Address - Street 2:
Mailing Address - City:DENVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07834-3612
Mailing Address - Country:US
Mailing Address - Phone:973-216-1008
Mailing Address - Fax:
Practice Address - Street 1:9 MOUNT PLEASANT TPKE STE 102
Practice Address - Street 2:
Practice Address - City:DENVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07834-3612
Practice Address - Country:US
Practice Address - Phone:973-216-1008
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-04
Last Update Date:2020-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00556300235Z00000X
FLSA 9640235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist