Debra Marlene Jackson, MS-CCC/SLP
Speech-Language Pathologist, in Edwardsville, IL. Individual provider (NPI-1).
NPI number1245282904
StatusActive
Last updated in NPPESAug 23, 2011
Details
- NPI
- 1245282904
- Entity type
- Individual (NPI-1)
- Name
- Ms. Debra Marlene Jackson
- Credential
- MS-CCC/SLP
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- May 17, 2006
- Last updated
- Aug 23, 2011
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 235Z00000X | Speech-Language Pathologist, | 146003388 | IL | Yes |
Practice location
1219 Troy RdEdwardsville, IL 62025-2363
Phone 618-960-7696 · Fax 130-921-6271
Mailing address
1219 Troy RdEdwardsville, IL 62025-2363
Phone 618-960-7696 · Fax 130-921-6271
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- Dayna Lynn Berry, MS CCC-SLPNPI 1871888651
- Elizabeth Marie Bray, MS, CCC-SLPNPI 1578040572
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All 48 Speech-Language Pathologist providers in Edwardsville · All 899 providers in Edwardsville
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