Mathiesen, Jackie Lynn
Mathiesen, Jackie Lynn is an individual health care provider with primary practice located at 12409 W Indian School Rd Ste C306 , Avondale AZ 85323-9508. 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. Mathiesen, Jackie Lynn can be contacted via phone (623) 935-6040.Contact Information
Primary practice address
12409 W Indian School Rd Ste C306
Avondale AZ 85323-9508
Phone: (623) 935-6040
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Speech, Language and Hearing Service Providers / Speech-Language Pathologist | 235Z00000X | SLP4480 | Arizona |
Profile Details
| NPI number | 1952441602 |
|---|---|
| LBN Legal business name | Mathiesen, Jackie Lynn |
| Credentials | M.S. CCC-SLP |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 8th, 2007 |
| Last updated | Jul 8th, 2007 - about 19 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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