Individual
LISA ANN JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A., CCC-SLP
Contact information
Practice address
802 S YUCATAN DR, TUCSON, AZ 85710-4933
(520) 203-6515
Mailing address
802 S YUCATAN DR, TUCSON, AZ 85710-4933
(520) 203-6515
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP4623
AZ
Other
Enumeration date
11/15/2019
Last updated
11/15/2019
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