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Individual

MS. JACIE NICOLE WESTBROOK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.S., CCC-SLP

Contact information

Practice address
1510 N GRAND AVE, TAHLEQUAH, OK 74464-6318
(918) 708-2119
(888) 391-9543
Mailing address
1510 N GRAND AVE, TAHLEQUAH, OK 74464-6318
(918) 708-2119
(888) 391-9543

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP5942
OK

Other

Enumeration date
05/13/2021
Last updated
05/04/2023
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