Provider Demographics
NPI:1154737146
Name:STROUD, JAYMA LYNN (MS SLP)
Entity type:Individual
Prefix:
First Name:JAYMA
Middle Name:LYNN
Last Name:STROUD
Suffix:
Gender:F
Credentials:MS SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:813 S 14TH ST
Mailing Address - Street 2:
Mailing Address - City:HERRIN
Mailing Address - State:IL
Mailing Address - Zip Code:62948-4101
Mailing Address - Country:US
Mailing Address - Phone:618-944-0832
Mailing Address - Fax:
Practice Address - Street 1:813 S 14TH ST
Practice Address - Street 2:
Practice Address - City:HERRIN
Practice Address - State:IL
Practice Address - Zip Code:62948-4101
Practice Address - Country:US
Practice Address - Phone:618-944-0832
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-10
Last Update Date:2014-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist