Individual
DOROTHY MACHELLE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1310 E SALCEDO RD, SIKESTON, MO 63801-5049
(573) 471-0653
Mailing address
1497 COUNTY HIGHWAY 714, EAST PRAIRIE, MO 63845-8106
(573) 233-2819
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
2021004309
MO
Other
Enumeration date
02/05/2024
Last updated
02/05/2024
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