Jazlyn Hacker

Individual provider Active NPI Speech-Language Pathologist · London, KY

NPI 1649013145 · NPPES record last updated Jun 13, 2024

Key facts

NPI
1649013145
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
292963 (KY)
Practice address
181 Old Whitley Rd
London, KY 40744-8211
Phone
(606) 330-0223
Fax
(606) 330-0228
NPI assigned
Jun 13, 2024
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
292963KYMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 292963 KY Yes

Addresses

Primary practice location

181 Old Whitley Rd
London, KY 40744-8211

Mailing address

181 Old Whitley Rd
London, KY 40744-8211
Phone (606) 330-0223

Other providers in London, KY

All providers in London, KY · Speech-Language Pathologist in Kentucky

Sources for this page

Verify at the official NPI Registry.