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1114973559
TARA MICHELE JACKSON
CHARLOTTE, NC
NPI
1114973559
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
235Z00000X Speech-Language Pathologist,
(Licence: NC 5772)
Enumeration Date
2006-05-26
Last Update Date
2011-07-02
Business Address
Mrs. TARA MICHELE JACKSON MA, CCC-SLP
3403 LINDEN BERRY LN
CHARLOTTE, NC 28269-1300
Phone number: 704-258-1724
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Mailing Address
Mrs. TARA MICHELE JACKSON MA, CCC-SLP
3403 LINDEN BERRY LANE
CHARLOTTE, NC 28269-1300
Phone number: 704-898-2437
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