Individual
MRS. JACKLYN ZASTROW MCDONALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
1010 STATE ST, MCCALL, ID 83638-3704
(208) 634-5909
(208) 634-5956
Mailing address
PO BOX 1512, MCCALL, ID 83638-1512
(208) 634-8030
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP1321
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12057142
ASHA
—
Enumeration date
12/27/2006
Last updated
11/29/2010
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