Petrina F Jackson in Blue Island - Speech-language Pathologist
Petrina F Jackson - NPI 1952476822
Petrina F Jackson is a Speech-language Pathologist in Blue Island, Illinois. Petrina F Jackson practices all healthcare services and medical treatments related to Speech-language Pathologist. The NPI Number for Petrina F Jackson is 1952476822. The last update date is 2007-07-08.
Petrina F Jackson's current location address is 12224 Fairway Cir, Blue Island, Illinois. You can contact this provider via phone number 7088249524 and fax number 7088249524. The mailing address for Petrina F Jackson is 12224 Fairway Cir, Blue Island, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Petrina F Jackson |
|---|---|
| Address | 12224 Fairway Cir, Blue Island, Illinois |
| Phone Number | 7088249524 |
| Fax Number | 7088249524 |
| Sole Proprietor | Y |
| Credentials | M.S., CCC- |
NPI Number Detail
| NPI Number | 1952476822 |
|---|---|
| Provider Enumeration Date | 2006-11-22 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 12224 Fairway Cir |
|---|---|
| City | Blue Island |
| State | Illinois (IL) |
| Post Code | 604063611 |
| Phone Number | 7088249524 |
| Fax Number | 7088249524 |
Provider's Primary Taxonomy Detail
| Speciality | Speech-language Pathologist |
|---|---|
| Taxonomy | 235Z00000X |
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Definition: The speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Spe |
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Post Comment/ Review Below
What is the unique 10-digit identifier code assigned to Petrina F Jackson by the Centers for Medicare & Medicaid Services?
The Petrina F Jackson has been issued the NPI (National Provider Identifier) 1952476822 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Could you please share the complete physical location address where Petrina F Jackson's facilities are situated?
The facilities of Petrina F Jackson are physically located at the following address: 12224 Fairway Cir, Blue Island, IL, 604063611.
What is the Petrina F Jackson's specialty and taxonomy code?
The Petrina F Jackson's specialty is Speech-language Pathologist, and the corresponding taxonomy code is 235Z00000X.
On what date did the Centers for Medicare & Medicaid Services assign the 1952476822 to Petrina F Jackson?
The Centers for Medicare & Medicaid Services assigned the 1952476822 to Petrina F Jackson on 2006-11-22.
When was the information pertaining to Petrina F Jackson most recently updated or revised?
The details related to Petrina F Jackson, including its address, specialty, and other relevant information, were last updated or revised on 2007-07-08.