Individual
JACQUELINE SHAWN BUTLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC/SLP
Contact information
Practice address
1300 JACKSON ST, ALEXANDRIA, LA 71301-6929
(318) 448-3848
Mailing address
1300 JACKSON ST, ALEXANDRIA, LA 71301-6929
(318) 448-3848
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
4565
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1720208
—
LA
Enumeration date
04/18/2008
Last updated
04/18/2008
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