Individual
KELLY JAKSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1085 S LINDEN RD STE 100, FLINT, MI 48532-3416
(810) 262-2007
Mailing address
2179 FOX HILL DR APT 11, GRAND BLANC, MI 48439-5232
(989) 854-0255
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
7101005864
MI
Other
Enumeration date
07/17/2018
Last updated
07/17/2018
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