| Doctor Name: | MS. JACQUELINE GAIL HUMENICK |
| NPI Number: | 1891800363 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.S. CCC/SLP |
| License Number: | SA 7244 |
| Business Practice Address: | 2818 Rolling Acres Pl Valrico, FL - 335945683 |
| Business Phone Number: | 8136252269 |
| Business Fax Number: | 8136537240 |
| Mailing Address: | 2818 Rolling Acres Pl, VALRICO |
| State: | FL |
| Postal Code: | 335945683 |
| Phone Number: | 8136252269 |
| Fax Number: | 8136537240 |
| NPI Enumeration Date: | 08/21/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | SA 7244 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| 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 |