Doctor Name: | MRS. DONNA JACKSON |
NPI Number: | 1912324229 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MS, CCC/SLP |
License Number: | 1324 |
Business Practice Address: | 141 Lloyd Rd West Union, OH - 456938974 |
Business Phone Number: | 9375445586 |
Business Fax Number: | |
Mailing Address: | 287 W Maple Leaf Rd, MAYSVILLE |
State: | KY |
Postal Code: | 410568138 |
Phone Number: | 6065648243 |
Fax Number: | |
NPI Enumeration Date: | 03/25/2014 |
NPI Last Update Date: | 03/25/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 1324 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | KY |
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 |