JACKIE LYNN MATHIESEN

AVONDALE, AZ
NPI1952441602
Former NameJACKIE LYNN JOHNSTON
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy235Z00000X Speech-Language Pathologist,
(Licence: AZ  SLP4480)
Enumeration Date2007-02-08
Last Update Date2007-07-08
Business Address
Mrs. JACKIE LYNN MATHIESEN M.S. CCC-SLP
12409 W INDIAN SCHOOL RD STE C306
AVONDALE, AZ 85323-9508
Phone number: 623-935-6040
Mailing Address
Mrs. JACKIE LYNN MATHIESEN M.S. CCC-SLP
14408 W DESERT COVE RD
SURPRISE, AZ 85379-4334
Phone number:
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