| Doctor Name: | MISS JACELYN HALL |
| NPI Number: | 1306175740 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | SA11268 |
| Business Practice Address: | 630 N. Maitland Avenue Maitland, FL - 32751 |
| Business Phone Number: | 4075392488 |
| Business Fax Number: | 4075392408 |
| Mailing Address: | 630 N. Maitland Avenue, MAITLAND |
| State: | FL |
| Postal Code: | 32751 |
| Phone Number: | 4075392488 |
| Fax Number: | 4075392408 |
| NPI Enumeration Date: | 12/14/2009 |
| NPI Last Update Date: | 06/04/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | SA11268 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| 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 |