Lisa Nicole Jackson B.A. SLPA

NPI 1720493224 - Specialist/Technologist - 2355S0801X

NPI Details
NPI 1720493224
Gender Female
Enumeration Date 06/24/2014
Last Updated 06/24/2014
Entity Type Individual
Active Over 2 years ago
Practice Location
3200 TROUP HWY STE, 120
TYLER TX, 75701, US
Phone (903) 253-0095
Fax
Business Location
3200 TROUP HWY STE 120
TYLER TX, 75701-8364, US
Phone (903) 253-0095
Fax
Toxanomy
Taxonomy Code 2355S0801X
License State Texas
License Number 37923
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According to our database, Lisa Nicole Jackson B.A. SLPA NPI is 1720493224, taxonomy code is 2355S0801X and license number is 37923, license state is located at Texas. Lisa Nicole Jackson B.A. SLPA physically located at 3200 Troup Hwy Ste, 120, Tyler TX, 75701. NPI Number Lisa Nicole Jackson B.A. SLPA has the Individual type.

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1720493224 NPI number is provided on an as is basis without warranty of any kind. 1720493224 is maintained by the National Plan & Provider Enumeration System. The contents of Lisa Nicole Jackson B.A. SLPA are for informational purposes only.