Individual
MRS. JACQUELYN S DEWAAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A., CCC-SLP
Contact information
Practice address
1096 34TH ST, ALLEGAN, MI 49010-9305
(269) 365-3279
(269) 781-9290
Mailing address
1096 34TH ST, ALLEGAN, MI 49010-9305
(269) 365-3279
(269) 781-9290
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
7101006233
MI
235Z00000X
Speech-Language Pathologist
Primary
7101006797
MI
Other
Enumeration date
09/03/2019
Last updated
02/16/2022
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