Individual
JACALYN BAXENDALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, CCC-SLP
Contact information
Practice address
29000 INFORMATION LN STE 507, EASTON, MD 21601-7032
(410) 822-2213
Mailing address
106 BOUNDARY LN, ST MICHAELS, MD 21663-2616
(856) 701-3117
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
08237
MD
235Z00000X
Speech-Language Pathologist
41YS00658900
NJ
235Z00000X
Speech-Language Pathologist
SL010169
PA
Other
Enumeration date
04/11/2012
Last updated
12/01/2020
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