Doctor Name: | MS. JOI JACKSON |
NPI Number: | 1174767685 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | SLP005032 |
Business Practice Address: | 3249 Liberty Commons Dr Nw Kennesaw, GA - 301442322 |
Business Phone Number: | 7708261334 |
Business Fax Number: | |
Mailing Address: | 3249 Liberty Commons Dr Nw, KENNESAW |
State: | GA |
Postal Code: | 301442322 |
Phone Number: | 7708261334 |
Fax Number: | |
NPI Enumeration Date: | 04/28/2009 |
NPI Last Update Date: | 04/28/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SLP005032 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
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 |