Organization
JACI DALE SPEECH PATHOLOGY SERVICES, LLC
Active
Other names
Jaci Dale DBA Jaci Dale
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JACI RAE DALE M.S., CCC-SLP (OWNER)
(618) 253-7019
Entity
Organization
Contact information
Practice address
701 S LEDFORD ST, HARRISBURG, IL 62946-2532
(618) 253-7019
(618) 253-7019
Mailing address
701 S LEDFORD ST, HARRISBURG, IL 62946-2532
(618) 253-7019
(618) 253-7019
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
146.005513
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1275662728
NPI
IL
Enumeration date
10/26/2015
Last updated
10/26/2015
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