Individual
DANIELLE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2150 S COUNTRY CLUB DR, SUITE 20, MESA, AZ 85210-6809
(480) 398-4280
(480) 398-4281
Mailing address
PO BOX 50218, PHOENIX, AZ 85076-0218
(480) 398-4280
(480) 398-4281
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP9811
AZ
235Z00000X
Speech-Language Pathologist
TSLP9811
AZ
Other
Enumeration date
01/26/2016
Last updated
04/21/2026
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