Individual
DEASIA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3712 DAUPHIN ST, MOBILE, AL 36608-1725
(251) 304-3000
Mailing address
245 CAHABA VALLEY PKWY, PELHAM, AL 35124-2216
(205) 942-6820
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
5345
AL
Other
Enumeration date
07/07/2023
Last updated
07/07/2023
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