Individual
JACQUELYN MACIAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2100 E MARTIN LUTHER KING JR BLVD, AUSTIN, TX 78702-1342
(512) 900-7934
Mailing address
11305 ASHBROOK DR, MANCHACA, TX 78652-3517
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
36840
TX
Other
Enumeration date
11/25/2017
Last updated
11/25/2017
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