| Organization Name: | JAESAN INC |
| NPI Number: | 1003940933 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KAI ANE JERRELL (SPEECH LANGUAGE PATHOLOGIST) |
| Mailing Address: | 7900 Matthews Mint Hill Rd 115 Mint Hill |
| State: | NC US |
| Postal Code: | 282276514 |
| Phone Number: | 9802376226 |
| Fax Number: | 9802376288 |
| NPI Enumeration Date: | 03/15/2007 |
| NPI Last Update Date: | 12/04/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 6278 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NC |
| 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 |