Jaclyn Carr

Individual provider Active NPI Speech-Language Pathologist · Wilmington, DE

NPI 1750002879 · NPPES record last updated Sep 7, 2022

Key facts

NPI
1750002879
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
O1-0001772 (DE)
Practice address
1311 Brandywine Blvd
Wilmington, DE 19809-2306
Phone
(302) 529-3118
NPI assigned
Sep 7, 2022
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
O1-0001772DEMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X O1-0001772 DE Yes

Addresses

Primary practice location

1311 Brandywine Blvd
Wilmington, DE 19809-2306

Mailing address

1311 Brandywine Blvd
Wilmington, DE 19809-2306

Other providers in Wilmington, DE

All providers in Wilmington, DE · Speech-Language Pathologist in Delaware

Sources for this page

Verify at the official NPI Registry.