Individual
MRS. MICHELLE N JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SPEECH PATHOLOGIST
Contact information
Practice address
118 MEDICAL DRIVE, LIFESPAN THERAPY, CARMEL, IN 46032-2923
(317) 817-8874
Mailing address
118 MEDICAL DRIVE, LIFESPAN THERAPY, CARMEL, IN 46032-2923
(317) 817-8874
(812) 257-0039
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
46002415A
IN
Other
Enumeration date
01/10/2013
Last updated
01/07/2016
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