Doctor Name: | MS. JACIE JEAN POLLARD |
NPI Number: | 1891959235 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S., CCC-SLP |
License Number: | SLP-1749 |
Business Practice Address: | 1110 Call Creek Dr Suite #7 Pocatello, ID - 832013072 |
Business Phone Number: | 2082334660 |
Business Fax Number: | 2082334262 |
Mailing Address: | 1333 N Main St, POCATELLO |
State: | ID |
Postal Code: | 832042609 |
Phone Number: | 2082690480 |
Fax Number: | |
NPI Enumeration Date: | 07/15/2008 |
NPI Last Update Date: | 07/15/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SLP-1749 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | ID |
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 |