| Doctor Name: | MS. JACQUELYN A KUCIA |
| NPI Number: | 1053517615 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MACCC.SLP |
| License Number: | SP 6236 |
| Business Practice Address: | 1645 Maplewood Dr Streetsboro, OH - 442415662 |
| Business Phone Number: | 3306263031 |
| Business Fax Number: | 3306262699 |
| Mailing Address: | 2021 Newport Dr, INDIAN LAND |
| State: | SC |
| Postal Code: | 297075961 |
| Phone Number: | 2166501819 |
| Fax Number: | |
| NPI Enumeration Date: | 06/21/2007 |
| NPI Last Update Date: | 08/18/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | SP 6236 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| 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 |