Individual
JACLYN WEISS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6709 KACI LN, FORT MILL, SC 29707-3201
(803) 548-0369
Mailing address
6709 KACI LN, FORT MILL, SC 29707-3201
(803) 548-0369
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
016317-1
NY
235Z00000X
Speech-Language Pathologist
Primary
4366
SC
235Z00000X
Speech-Language Pathologist
7860
NC
Other
Enumeration date
11/05/2008
Last updated
11/05/2008
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