NPI | 1447696935 |
---|---|
Other Name | BECKY JACKSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: MO 2013029913) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: MO 2012019166) |
Enumeration Date | 2013-05-11 |
Last Update Date | 2022-07-13 |