Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MRS. KELLY GREEN JACKSON, S.L.P.
Active Sole ProprietorMRS. KELLY GREEN JACKSON, S.L.P. is a Speech, Language and Hearing Specialist healthcare provider located in LAKE PARK, Georgia. NPI 1083632467 is currently active in the NPPES registry. Verify at CMS.
Speech, Language and Hearing Specialist · LAKE PARK, GA
Registration Details
- NPI Number
- 1083632467
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Jul 17, 2006 (20.090533004086 yrs)
- Last Updated
- Jan 27, 2025
- License
-
SA8681 (FL)
- Sole Proprietor
- Yes
Practice Information
- Address
-
5314 MOSS OAK TRLLAKE PARK, GA, 316363300Browse GA providers · Browse ZIP 31636
- Phone
- 3863628564
- Primary Specialty
-
Speech, Language and Hearing Specialist
235Z00000X
Other Speech, Language and Hearing Specialist Providers in LAKE PARK, GA
| Name | Credential | NPI |
|---|---|---|
| NANCY HEATH | — | 1700359551 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.