| Doctor Name: | MRS. JAIME GAYLE FESUK |
| NPI Number: | 1386860120 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | SLPL4197 |
| Business Practice Address: | 146 S Granite St Prescott, AZ - 863034710 |
| Business Phone Number: | 9284455400 |
| Business Fax Number: | |
| Mailing Address: | 1998 Prescott Lakes Parkway, #141 PRESCOTT |
| State: | AZ |
| Postal Code: | 863017825 |
| Phone Number: | 9288300052 |
| Fax Number: | |
| NPI Enumeration Date: | 04/18/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | SLPL4197 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AZ |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |