| Doctor Name: | DR. CRISTINA A JACKSON-MENALDI |
| NPI Number: | 1649363722 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PHD |
| License Number: | |
| Business Practice Address: | 21000 E 12 Mile Rd Suite 111 Saint Clair Shores, MI - 480811116 |
| Business Phone Number: | 5867797610 |
| Business Fax Number: | |
| Mailing Address: | 21000 E 12 Mile Rd, Ste 111 ST CLAIR SHORES |
| State: | MI |
| Postal Code: | 48081 |
| Phone Number: | 5867797610 |
| Fax Number: | 5864452523 |
| NPI Enumeration Date: | 10/02/2006 |
| NPI Last Update Date: | 10/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| 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 |