Individual
JACKSON MONROE PRATHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.ED. CCC-SLP
Contact information
Practice address
100 MEREDITH DR, SUITE 100, DURHAM, NC 27713-5237
(919) 484-0012
Mailing address
4922 OLD PAGE RD APT 334, DURHAM, NC 27703-8095
(919) 215-3262
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
07/06/2010
Last updated
10/29/2012
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