| NPI | 1710548128 |
|---|---|
| Former Name | TRISH DEANA JACKSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2355S0801X Specialist/Technologist, Speech-Language Assistant (Licence: AZ SLPA11821) |
| Enumeration Date | 2019-06-26 |
| Last Update Date | 2019-06-26 |