Individual
JACLYN DEA HARTLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.,CCC-SLP
Contact information
Practice address
2471 KING ARTHURS CT, FORT MYERS, FL 33912-1640
(304) 288-6115
Mailing address
2471 KING ARTHURS CT, FORT MYERS, FL 33912-1640
(304) 288-6115
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
12668
FL
235Z00000X
Speech-Language Pathologist
SLP-1100
WV
Other
Enumeration date
07/27/2007
Last updated
08/03/2021
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