| NPI | 1871850115 |
|---|---|
| Former Name | JACALYN BENNETT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist (Licence: MD 08237) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist (Licence: PA SL010169) |
| 235Z00000X Speech-Language Pathologist (Licence: NJ 41YS00658900) | |
| Enumeration Date | 2012-04-11 |
| Last Update Date | 2020-12-01 |