Doctor Name: | MS. JACQUELINE DIANE JEFFRIES |
NPI Number: | 1225042187 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | BSC SLP |
License Number: | 2202001410 |
Business Practice Address: | 1400 Fordham Dr Virginia Beach, VA - 234645368 |
Business Phone Number: | 7573613954 |
Business Fax Number: | 7573613951 |
Mailing Address: | 1400 Fordham Dr, VIRGINIA BEACH |
State: | VA |
Postal Code: | 234645368 |
Phone Number: | 7573613954 |
Fax Number: | 7573613951 |
NPI Enumeration Date: | 07/28/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 2202001410 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VA |
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 |