Provider Demographics
NPI:1437707130
Name:PIZZA, JAMIE (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:
Last Name:PIZZA
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:JAMIE
Other - Middle Name:
Other - Last Name:FITZHUGH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:4040 TABERNACLE RD
Mailing Address - Street 2:
Mailing Address - City:WHITEFORD
Mailing Address - State:MD
Mailing Address - Zip Code:21160-1502
Mailing Address - Country:US
Mailing Address - Phone:443-243-3287
Mailing Address - Fax:
Practice Address - Street 1:901 TRIMBLE RD
Practice Address - Street 2:
Practice Address - City:JOPPA
Practice Address - State:MD
Practice Address - Zip Code:21085-4822
Practice Address - Country:US
Practice Address - Phone:410-612-1553
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-27
Last Update Date:2021-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD09446235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty