Doctor Name: | MRS. JILL E JACKSON |
NPI Number: | 1649469685 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MA, CCC-SLP |
License Number: | SP-7319 |
Business Practice Address: | 3099 Meadowbrook Blvd #1 Cleveland Heights, OH - 441182883 |
Business Phone Number: | 2163200879 |
Business Fax Number: | |
Mailing Address: | 3099 Meadowbrook Blvd, #1 CLEVELAND HEIGHTS |
State: | OH |
Postal Code: | 441182883 |
Phone Number: | 2163200879 |
Fax Number: | |
NPI Enumeration Date: | 10/16/2007 |
NPI Last Update Date: | 10/16/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SP-7319 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
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 |