Individual
COURTNEY JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
6180 HIGHWAY MM, HOUSE SPRINGS, MO 63051-2315
(636) 671-3382
Mailing address
5065 FOX BRIDGE RD, WILDWOOD, MO 63069-3203
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
07/28/2022
Last updated
07/28/2022
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