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1710544119
MARY GRACE JAQUES
JEFFERSON, GA
NPI
1710544119
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
235Z00000X Speech-Language Pathologist
(Licence: SLP010476)
Enumeration Date
2019-05-22
Last Update Date
2019-05-22
Business Address
MARY GRACE JAQUES M.ED., CCC-SLP
40 PROFESSIONAL DR
JEFFERSON, GA 30549-6333
Phone number: 114-170-6367
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Mailing Address
MARY GRACE JAQUES M.ED., CCC-SLP
475 BALDWIN ST APT 14
ATHENS, GA 30605-5152
Phone number: 706-399-1865
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