Provider Demographics
NPI:1528177466
Name:HANNON, JAIME LYNN (MS CCC-A)
Entity type:Individual
Prefix:MRS
First Name:JAIME
Middle Name:LYNN
Last Name:HANNON
Suffix:
Gender:F
Credentials:MS CCC-A
Other - Prefix:MISS
Other - First Name:JAIME
Other - Middle Name:LYNN
Other - Last Name:EHRET
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:541 MAIN ST STE 418
Mailing Address - Street 2:
Mailing Address - City:WEYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02190-1845
Mailing Address - Country:US
Mailing Address - Phone:781-337-6860
Mailing Address - Fax:
Practice Address - Street 1:541 MAIN ST STE 418
Practice Address - Street 2:
Practice Address - City:WEYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02190-1845
Practice Address - Country:US
Practice Address - Phone:781-337-6860
Practice Address - Fax:781-337-2103
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2017-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA812231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist