Jackson, Kendall
Jackson, Kendall is an sole proprietor health care provider with primary practice located at 3485 N Desert Dr Ste 105 , East Point GA 30344-5724. 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, Kendall can be contacted via phone (678) 724-7033.Contact Information
Primary practice address
3485 N Desert Dr Ste 105
East Point GA 30344-5724
Phone: (678) 724-7033
Fax: (678) 302-7357
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Speech, Language and Hearing Service Providers / Speech-Language Pathologist | 235Z00000X | SLP008103 | Georgia |
Profile Details
| NPI number | 1477818342 |
|---|---|
| LBN Legal business name | Jackson, Kendall |
| Credentials | SLP |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 6th, 2012 |
| Last updated | Aug 18th, 2023 - about 3 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1477818342 | NPPES |
| Georgia | MEDICAID | 003126519G |
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