Individual
MONIQUE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
120 BERNARD ST, SARALAND, AL 36571-2031
(251) 581-2341
Mailing address
1278 HILLARD HOWELL RD, LUCEDALE, MS 39452-9417
(251) 581-2341
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
4087
AL
Other
Enumeration date
01/01/2022
Last updated
01/01/2022
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