Individual
IRENE SHETZLINE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A. CCCSLP
Contact information
Practice address
1006 S COLUMBUS ST, ARLINGTON, VA 22204-3424
(703) 772-2449
Mailing address
1006 S COLUMBUS ST, ARLINGTON, VA 22204-3424
(703) 772-2449
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2202004915
VA
235Z00000X
Speech-Language Pathologist
4622
MD
Other
Enumeration date
03/05/2009
Last updated
03/05/2009
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