Individual
MS. JANETTE RHODES JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
1264 LAKESHORE DR, ORANGEBURG, SC 29115-7020
(803) 534-8609
(803) 534-8609
Mailing address
1264 LAKESHORE DR, ORANGEBURG, SC 29115-7020
(803) 534-8609
(803) 534-8609
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
740
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SA0025
—
SC
Enumeration date
09/14/2006
Last updated
07/09/2007
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