Provider Demographics
NPI:1659870954
Name:JAMES, JACKIE SCHOOLS X (SPEECH THERAPIST)
Entity Type:Individual
Prefix:MS
First Name:JACKIE
Middle Name:SCHOOLS
Last Name:JAMES
Suffix:X
Gender:F
Credentials:SPEECH THERAPIST
Other - Prefix:MS
Other - First Name:JACKIE
Other - Middle Name:SCHOOLS
Other - Last Name:JAMES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:SPEECH THERAPIST
Mailing Address - Street 1:PO BOX 2381
Mailing Address - Street 2:
Mailing Address - City:GLOUCESTER
Mailing Address - State:VA
Mailing Address - Zip Code:23061-2381
Mailing Address - Country:US
Mailing Address - Phone:804-436-3774
Mailing Address - Fax:
Practice Address - Street 1:6680 SHORT LN
Practice Address - Street 2:
Practice Address - City:GLOUCESTER
Practice Address - State:VA
Practice Address - Zip Code:23061-4410
Practice Address - Country:US
Practice Address - Phone:804-693-2526
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-02
Last Update Date:2018-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2200000578235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist