Jackson, Debra Marlene

Jackson, Debra Marlene is an sole proprietor health care provider with primary practice located at 1219 Troy Rd , Edwardsville IL 62025-2363. She recently has only one registered license in Speech, Language and Hearing Service Providers / Speech-Language Pathologist, which is considered as her primary health care specialty. Jackson, Debra Marlene can be contacted via phone (618) 960-7696.

Contact Information

Primary practice address
1219 Troy Rd Edwardsville IL 62025-2363
Fax: (130) 921-6271
Website:

Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X 146003388 Illinois

Profile Details

NPI number 1245282904
LBN Legal business name Jackson, Debra Marlene
Credentials MS-CCC/SLP
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 17th, 2006
Last updated Aug 23rd, 2011 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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