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Organization
JACI DALE SPEECH PATHOLOGY SERVICES, LLC
Active
Organization
JACI DALE SPEECH PATHOLOGY SERVICES, LLC
Active
Other names
Jaci Dale DBA Jaci Dale
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JACI RAE DALE M.S., CCC-SLP (OWNER)
(618) 253-7019
Entity
Organization
Contact information
Practice address
701 S LEDFORD ST, HARRISBURG, IL 62946-2532
(618) 253-7019
(618) 253-7019
Mailing address
701 S LEDFORD ST, HARRISBURG, IL 62946-2532
(618) 253-7019
(618) 253-7019
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
146.005513
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1275662728
NPI
IL
Enumeration date
10/26/2015
Last updated
10/26/2015
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