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KELSEY WINN JACKSON
>> Speech-Language Pathologist >> Speech, Language and Hearing Service ProvidersRegistrant NPI Number: 1013568799
Individual Registrant: KELSEY WINN JACKSON
Gender: F
Sole Proprietor
Gender: F
Sole Proprietor
Location and contact information for practice:
534 PERRY FARM RD SW CAVE SPRING, GA 30124-3024 US
Tel: 706-266-5593 Fax: --
Tel: 706-266-5593 Fax: --
Contact information for business:
534 PERRY FARM RD SW CAVE SPRING, GA 30124-3024 US
Tel: 706-266-5593 Fax: --
Tel: 706-266-5593 Fax: --
Registration Information:
NPI: 1013568799
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 235Z00000X | Speech, Language and Hearing Service Providers Speech-Language Pathologist | GA | PCET003028 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
