Doctor Name: | MRS. JACLYN GRETSKY |
NPI Number: | 1679903926 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MA CCC/SLP |
License Number: | SL008586 |
Business Practice Address: | 44 Donaldson Rd Tremont, PA - 179811424 |
Business Phone Number: | 5706953141 |
Business Fax Number: | 5706952264 |
Mailing Address: | 11 Donna Cir, POTTSVILLE |
State: | PA |
Postal Code: | 179018876 |
Phone Number: | 5703854252 |
Fax Number: | |
NPI Enumeration Date: | 11/24/2013 |
NPI Last Update Date: | 11/24/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SL008586 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
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 |