Individual
AMANDA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
22 NEW YORK RD, PLATTSBURGH, NY 12903-3981
(518) 593-5223
Mailing address
40 OLIVETTI PL, PLATTSBURGH, NY 12901-2614
(518) 593-5223
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
05/09/2016
Last updated
05/09/2016
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