Individual
JACKI ROY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
110 N MENTZER ST, MITCHELL, SD 57301-8001
(605) 995-3021
Mailing address
110 N MENTZER ST, MITCHELL, SD 57301-8001
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
416-SLP
SD
Other
Enumeration date
06/08/2016
Last updated
06/08/2016
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