Individual
ELIZABETH C JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
11535 CARMEL COMMONS BLVD, CHARLOTTE, NC 28226-5313
(704) 541-3737
(704) 540-9199
Mailing address
11535 CARMEL COMMONS BLVD, SUITE 100, CHARLOTTE, NC 28226-5313
(704) 541-3737
(704) 540-9199
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
12121284
NC
Other
Enumeration date
10/27/2009
Last updated
08/23/2010
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