Individual
JACLYN ELAINE NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
801 W WALL ST, MULBERRY GROVE, IL 62262-1049
(618) 326-8811
Mailing address
801 W WALL ST, MULBERRY GROVE, IL 62262-1049
(618) 326-8811
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
146.014045
IL
235Z00000X
Speech-Language Pathologist
—
IL
Other
Enumeration date
10/05/2017
Last updated
12/20/2021
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