Individual
JACQUELINE HART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
806 MORGAN LN, JACKSON, WY 83001-8968
(307) 734-3932
Mailing address
806 MORGAN LN, JACKSON, WY 83001-8968
(307) 734-3932
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP-2243
ID
Other
Enumeration date
08/01/2012
Last updated
09/09/2014
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