| Doctor Name: | LORI JANE JACKSON |
| NPI Number: | 1902205693 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.S. CCC-SLP |
| License Number: | SLP008987 |
| Business Practice Address: | 9100 White Bluff Rd Suite 202 Savannah, GA - 314064668 |
| Business Phone Number: | 9123358486 |
| Business Fax Number: | 9123353528 |
| Mailing Address: | 9100 White Bluff Rd, Suite 202 SAVANNAH |
| State: | GA |
| Postal Code: | 314064668 |
| Phone Number: | 9123358486 |
| Fax Number: | 9123353528 |
| NPI Enumeration Date: | 08/19/2014 |
| NPI Last Update Date: | 07/26/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | SLP008987 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| 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 |