Individual
JESSICA GAYTAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS SLP
Contact information
Practice address
1651 E NICKERSON AVE, BENTON HARBOR, MI 49022-2469
(269) 876-5697
Mailing address
1651 E NICKERSON AVE, BENTON HARBOR, MI 49022-2469
(269) 876-5697
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
7101007514
MI
Other
Enumeration date
08/13/2020
Last updated
09/03/2023
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