Individual
MRS. LASHUNDA DENISE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
1862 HIGHWAY 278 E, MONTICELLO, AR 71655-9192
(870) 367-1994
Mailing address
1862 HIGHWAY 278 E, MONTICELLO, AR 71655-9192
(870) 367-1994
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP #1214
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
133472721
—
AR
Enumeration date
12/08/2009
Last updated
12/08/2009
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