Individual
JACKLIN DEA BLOODGOOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
132 CRUISE RD, MANAHAWKIN, NJ 08050-1223
(732) 330-4557
Mailing address
132 CRUISE RD, MANAHAWKIN, NJ 08050-1223
(732) 330-4557
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
41YS01081900
NJ
Other
Enumeration date
11/02/2022
Last updated
11/02/2022
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