Doctor Name: | MISS JACLYN THOMAS |
NPI Number: | 1073916011 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 023857 |
Business Practice Address: | 1000 Clinton St Apt 1k Hoboken, NJ - 070303152 |
Business Phone Number: | 9178869082 |
Business Fax Number: | |
Mailing Address: | 281 Grantwood Ave, STATEN ISLAND |
State: | NY |
Postal Code: | 103121900 |
Phone Number: | 9178869082 |
Fax Number: | |
NPI Enumeration Date: | 10/05/2014 |
NPI Last Update Date: | 02/29/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 023857 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | NY |
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 |