Individual
DANIELLE FERNANDA JACKOVITZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.
Contact information
Practice address
25117 SW PARKWAY AVE, STE D, WILSONVILLE, OR 97070-9697
(971) 224-2040
Mailing address
25117 SW PARKWAY AVE, STE D, WILSONVILLE, OR 97070-9697
(971) 224-2040
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
02/01/2017
Last updated
02/01/2017
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