STACI TATE JACKSON

WINSTON SALEM, NC
NPI1316172778
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy235Z00000X Speech-Language Pathologist,
(Licence: NC  6933)
Enumeration Date2009-05-28
Last Update Date2013-10-21
Business Address
Mrs. STACI TATE JACKSON SLP
4917 SOUTHWIN DR
WINSTON SALEM, NC 27104-4634
Phone number: 336-287-2175
Mailing Address
Mrs. STACI TATE JACKSON SLP
4917 SOUTHWIN DR
WINSTON SALEM, NC 27104-4634
Phone number: 336-287-2175
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