Individual
JACLYN MICHELLE CASERTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
2110 MOON STATION DR NW, KENNESAW, GA 30144-2759
(627) 770-2267
Mailing address
2110 MOON STATION DR NW, KENNESAW, GA 30144-2759
(627) 770-2267
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
13415
NC
235Z00000X
Speech-Language Pathologist
Primary
SLP010583
GA
Other
Enumeration date
03/28/2019
Last updated
08/04/2022
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