Individual
EMILY ELISE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLPA
Contact information
Practice address
1149 W 190TH ST STE 2300, GARDENA, CA 90248-4350
(310) 892-5812
Mailing address
1149 W 190TH ST STE 2300, GARDENA, CA 90248-4350
(562) 884-7640
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
7495
CA
Other
Enumeration date
12/20/2023
Last updated
02/16/2024
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