Individual
ELLEN STRATTON JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.
Contact information
Practice address
5604 VIRGINIA BEACH BLVD, VIRGINIA BEACH, VA 23462-5631
(757) 455-5000
Mailing address
5604 VIRGINIA BEACH BLVD, VIRGINIA BEACH, VA 23462-5631
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2204001244
VA
Other
Enumeration date
08/14/2023
Last updated
08/14/2023
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