Individual
JACQUELYN SUE SHAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S CCC-SLP
Contact information
Practice address
1111 HOLCOMBE ST S, STILLWATER, MN 55082-5736
(651) 351-2361
Mailing address
1111 HOLCOMBE ST S, STILLWATER, MN 55082-5736
(651) 351-2361
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
8373
MN
Other
Enumeration date
04/13/2009
Last updated
03/27/2013
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