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Individual
KRYSTAL JAQUISH
Active
Individual
KRYSTAL JAQUISH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A., SLP-CCC, TSLD
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
968174151
NY
235Z00000X
Speech-Language Pathologist
Primary
027551
NY
Other
Enumeration date
08/31/2015
Last updated
12/07/2020
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