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Individual
GARRET JOHN JANSEN
Active
Individual
GARRET JOHN JANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
SPEECH PATHOLOGIST
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
109225
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
109225
LICENSE
IA
Enumeration date
06/15/2021
Last updated
06/23/2021
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