Individual
CASEY JACOB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, CF-SLP
Contact information
Practice address
15372 SW 51ST MNR, DAVIE, FL 33331-2847
(954) 504-8256
Mailing address
15372 SW 51ST MNR, DAVIE, FL 33331-2847
(954) 504-8256
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SZ7637
FL
Other
Enumeration date
05/11/2017
Last updated
05/11/2017
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