Individual
MISS JACKALYN PATRICIA FISHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
2120 SUNNYMEDE DR, FORT WAYNE, IN 46803-3137
(419) 518-0267
Mailing address
2120 SUNNYMEDE DR, FORT WAYNE, IN 46803-3137
(419) 518-0267
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP.14973
OH
235Z00000X
Speech-Language Pathologist
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/08/2020
Last updated
07/28/2026
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