Individual
JENNA LYNN CHACKAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1003 WYOMING AVE, FORTY FORT, PA 18704-4002
(570) 846-0455
Mailing address
1003 WYOMING AVE, FORTY FORT, PA 18704-4002
(570) 846-0455
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SL018349
PA
Other
Enumeration date
06/04/2024
Last updated
04/28/2025
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