Individual
MATTHEW THOMAS JACQUOT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
22722 LAMBERT ST STE 611, LAKE FOREST, CA 92630-1633
(949) 429-8161
Mailing address
22722 LAMBERT ST STE 611, LAKE FOREST, CA 92630-1633
(949) 429-8161
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
8098
CA
Other
Enumeration date
01/30/2024
Last updated
01/30/2024
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