Provider Demographics
NPI:1275991804
Name:HOSKINS, JACKLYN SUE
Entity Type:Individual
Prefix:
First Name:JACKLYN
Middle Name:SUE
Last Name:HOSKINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JACKLYN
Other - Middle Name:SUE
Other - Last Name:LOWE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1208 N LINCOLN ST
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:IA
Mailing Address - Zip Code:50138-3421
Mailing Address - Country:US
Mailing Address - Phone:641-628-6623
Mailing Address - Fax:641-621-2223
Practice Address - Street 1:1208 N LINCOLN ST
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:IA
Practice Address - Zip Code:50138-3421
Practice Address - Country:US
Practice Address - Phone:641-628-6623
Practice Address - Fax:641-621-2223
Is Sole Proprietor?:No
Enumeration Date:2016-02-10
Last Update Date:2020-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA002263235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA002263OtherIOWA LICENSE