Individual
CASSIDY JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
131 DRUMLIN CT, NEWARK, NY 14513-1863
(315) 332-7400
Mailing address
105 WATSON DR, WARRENDALE, PA 15086-1110
(412) 552-9578
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
016376
PA
235Z00000X
Speech-Language Pathologist
Primary
035435
NY
235Z00000X
Speech-Language Pathologist
11152
MD
Other
Enumeration date
06/19/2022
Last updated
10/07/2025
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