Individual
ALEXANDRA MAYNARD JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
929 N SAINT FRANCIS AVE, WICHITA, KS 67214-3821
(316) 268-5000
Mailing address
11622 W RYAN PL, WICHITA, KS 67205-2188
(913) 378-4768
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
5347
KS
Other
Enumeration date
08/03/2023
Last updated
08/03/2023
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