| NPI | 1710599808 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAARON DONNA JACKSON Speech Language Pathologist 907-317-3727 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Enumeration Date | 2020-08-19 |
| Last Update Date | 2020-08-19 |