| NPI | 1982971842 |
|---|---|
| Former Name | JENNIFER LYNN JACKSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: FL SA11884) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: WV slp-1267) |
| Enumeration Date | 2011-11-21 |
| Last Update Date | 2023-04-06 |