Individual
JASANDA WYKETTA NETTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
607 ROSEMARY RD, APT. # 39, CLEVELAND, MS 38732-2053
(662) 719-1825
Mailing address
607 ROSEMARY RD, APT. # 39, CLEVELAND, MS 38732-2053
(662) 719-1825
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
S3046
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04471273
—
MS
Enumeration date
08/12/2010
Last updated
08/12/2010
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