| Doctor Name: | RACHEL JACOB |
| NPI Number: | 1073971552 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.S. CCC-SLP |
| License Number: | 9554558-4102 |
| Business Practice Address: | 25117 Sw Parkway Ave Ste D Wilsonville, OR - 970709697 |
| Business Phone Number: | 5035703665 |
| Business Fax Number: | |
| Mailing Address: | 7650 S Euro Dr, F303 MIDVALE |
| State: | UT |
| Postal Code: | 840475049 |
| Phone Number: | 6186945097 |
| Fax Number: | |
| NPI Enumeration Date: | 01/29/2016 |
| NPI Last Update Date: | 01/29/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 9554558-4102 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | UT |
| 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 |