Individual
MRS. JACQUELINE RAE TYRELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS CCC-SLP
Contact information
Practice address
145 TIVOLI WAY, SACRAMENTO, CA 95819-1933
(916) 426-8374
Mailing address
145 TIVOLI WAY, SACRAMENTO, CA 95819-1933
(916) 426-8374
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
8276
CA
Other
Enumeration date
10/15/2018
Last updated
10/15/2018
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