| NPI | 1952617656 |
|---|---|
| Former Name | JACLYN J WILLETTE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: CT 4160) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: NY 021031) |
| Enumeration Date | 2010-08-19 |
| Last Update Date | 2016-06-22 |