Individual
JESSICA LYNN BAKO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
109 JEFFREY DR, JOHNSTOWN, PA 15905-1323
(814) 279-0461
Mailing address
109 JEFFREY DR, JOHNSTOWN, PA 15905-1323
(814) 279-0461
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SL009281
PA
Other
Enumeration date
09/09/2015
Last updated
09/09/2015
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