Provider Demographics
NPI:1487880597
Name:JONAITIS, PATRICIA LAMAR (MA, CCC/SLP)
Entity type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:LAMAR
Last Name:JONAITIS
Suffix:
Gender:F
Credentials:MA, CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:61 COOPER ST
Mailing Address - Street 2:
Mailing Address - City:NATCHEZ
Mailing Address - State:MS
Mailing Address - Zip Code:39120-2311
Mailing Address - Country:US
Mailing Address - Phone:601-446-9479
Mailing Address - Fax:
Practice Address - Street 1:61 COOPER ST
Practice Address - Street 2:
Practice Address - City:NATCHEZ
Practice Address - State:MS
Practice Address - Zip Code:39120-2311
Practice Address - Country:US
Practice Address - Phone:601-446-9479
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-03
Last Update Date:2009-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSS3138235Z00000X
LA5692235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist