Individual
MRS. ELAINE MARIE JACQUES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
350 TERRACINA BLVD, REDLANDS, CA 92373-4850
(909) 335-5500
Mailing address
1107 W OLIVE AVE, REDLANDS, CA 92373-5022
(714) 757-3846
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
15110
CA
Other
Enumeration date
07/20/2007
Last updated
06/12/2012
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