Provider Demographics
NPI:1699965111
Name:FARIAS, JAMIE-LYNNE (ATC)
Entity type:Individual
Prefix:MRS
First Name:JAMIE-LYNNE
Middle Name:
Last Name:FARIAS
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:MISS
Other - First Name:JAMIE-LYNNE
Other - Middle Name:
Other - Last Name:ARUNDEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ATC
Mailing Address - Street 1:67 UNION ST
Mailing Address - Street 2:
Mailing Address - City:NATICK
Mailing Address - State:MA
Mailing Address - Zip Code:01760-7700
Mailing Address - Country:US
Mailing Address - Phone:508-650-7275
Mailing Address - Fax:508-650-7271
Practice Address - Street 1:67 UNION ST
Practice Address - Street 2:
Practice Address - City:NATICK
Practice Address - State:MA
Practice Address - Zip Code:01760-7700
Practice Address - Country:US
Practice Address - Phone:508-650-7275
Practice Address - Fax:508-650-7271
Is Sole Proprietor?:No
Enumeration Date:2007-07-31
Last Update Date:2007-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA17012255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer