Individual
MRS. JACQUELINE ANNE WADE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP-CCC
Contact information
Practice address
3006 W KENT DR, CARBONDALE, IL 62901-1921
(618) 549-7784
(618) 549-7784
Mailing address
3006 W KENT DR, CARBONDALE, IL 62901-1921
(618) 549-7784
(618) 549-7784
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
IL
Other
Enumeration date
03/06/2007
Last updated
07/08/2007
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