Doctor Name: | MRS. JESSICA EVANS JAKOBE |
NPI Number: | 1699085910 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 011700 |
Business Practice Address: | 141 Petrova Ave Petrova Elementary Saranac Lake, NY - 12983 |
Business Phone Number: | 5188971673 |
Business Fax Number: | |
Mailing Address: | 16 Tebbutt Road, P.o. Box 260 RAINBOW LAKE |
State: | NY |
Postal Code: | 12976 |
Phone Number: | 5183273184 |
Fax Number: | |
NPI Enumeration Date: | 10/20/2010 |
NPI Last Update Date: | 10/20/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 011700 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
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 |