Individual
MISS JACKALYN PATRICIA SIEBENALER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2030 JERICHO RD, HICKSVILLE, OH 43526-9324
(419) 518-0267
Mailing address
2030 JERICHO RD, HICKSVILLE, OH 43526-9324
(419) 518-0267
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/08/2020
Last updated
08/12/2021
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