| Organization Name: | ISLAND SPEECH LANGUAGE & REHABILITATION, INC. |
| NPI Number: | 1831339928 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JACKIE D. LONG (OWNER) |
| Mailing Address: | 390 Ne Midway Blvd Suite B-101 Oak Harbor |
| State: | WA US |
| Postal Code: | 982772642 |
| Phone Number: | 3606794211 |
| Fax Number: | 3602792545 |
| NPI Enumeration Date: | 03/02/2009 |
| NPI Last Update Date: | 03/02/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | LL0003493 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| 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 |