Doctor Name: | MRS. JESSICA LINDSAY JACKSON |
NPI Number: | 1619216850 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | 2905 River Rd Redfield, AR - 721329105 |
Business Phone Number: | 5014139486 |
Business Fax Number: | |
Mailing Address: | 2905 River Rd, REDFIELD |
State: | AR |
Postal Code: | 721329105 |
Phone Number: | 5014139486 |
Fax Number: | |
NPI Enumeration Date: | 02/07/2013 |
NPI Last Update Date: | 02/07/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2355S0801X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AR |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Specialist/Technologist |
Taxonomy Specialization: | Speech-Language Assistant |
Taxonomy Definition: |