National Provider Identifier

Elizabeth R Jagoda, MS CCC SLP/L

Elizabeth R Jagoda, MS CCC SLP/L is listed in the NPPES registry with a primary specialty of Speech-Language Pathologist in Jamestown, NY and a listed phone number of (716) 338-0668.

NPI 1619294758Jamestown, NYSpeech-Language Pathologist

Profile Overview

NPI
1619294758
Provider Type
Individual
Primary Specialty
Speech-Language Pathologist
Enumeration Date
April 29, 2010
Last Updated
November 25, 2013

Practice Location

  • 774 Fairmount Ave
  • Jamestown, NY 14701-2609

Phone: (716) 338-0668

Mailing Address

  • 774 Fairmount Ave
  • Billing Department
  • Jamestown, NY 14701-2609

Specialties

  • Speech-Language Pathologist (235Z00000X)
Full Record
NPI
1619294758
Entity Type
Individual
Last Name
Jagoda
First Name
Elizabeth
Middle Name
R
Credential
MS CCC SLP/L
Provider Other Last Name
Wilger
Provider Other First Name
Elizabeth
Provider Other Middle Name
R
Provider Other Credential Text
MS CCC-SLP/L
Provider Other Last Name Type Code
1
Mailing Street Address
774 Fairmount Ave
Mailing Address Line 2
Billing Department
Mailing City
Jamestown
Mailing State
NY
Mailing ZIP Code
14701-2609
Mailing Country
US
Mailing Phone
(716) 338-0668
Mailing Fax
(866) 694-4979
Practice Street Address
774 Fairmount Ave
Practice City
Jamestown
Practice State
NY
Practice ZIP Code
14701-2609
Practice Country
US
Practice Phone
(716) 338-0668
Practice Fax
(866) 694-4979
Enumeration Date
April 29, 2010
Last Updated
November 25, 2013
Sex
Female
Sole Proprietor
Yes
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Speech-Language Pathologist (235Z00000X)