Individual
MRS. JACQUELYN BROOKE LETHERMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
101 TERRACE DR, LOOGOOTEE, IN 47553-2207
(812) 296-1350
Mailing address
101 TERRACE DRIVE, LOOGOOTEE, IN 47553
(812) 296-1350
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
22007261A
IN
Other
Enumeration date
02/11/2020
Last updated
09/07/2021
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