Doctor Name: | JACLYN WEISS |
NPI Number: | 1174777171 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 7860 |
Business Practice Address: | 6709 Kaci Ln Fort Mill, SC - 297073201 |
Business Phone Number: | 8035480369 |
Business Fax Number: | |
Mailing Address: | 6709 Kaci Ln, FORT MILL |
State: | SC |
Postal Code: | 297073201 |
Phone Number: | 8035480369 |
Fax Number: | |
NPI Enumeration Date: | 11/05/2008 |
NPI Last Update Date: | 11/05/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 7860 |
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 |