Provider Demographics
NPI:1790560639
Name:JOUETT, JACQUELYN LINEA (AUD, CCC-A)
Entity Type:Individual
Prefix:DR
First Name:JACQUELYN
Middle Name:LINEA
Last Name:JOUETT
Suffix:
Gender:F
Credentials:AUD, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 KNIGHTSBRIDGE RD # 1-1207
Mailing Address - Street 2:
Mailing Address - City:FARMERS BRANCH
Mailing Address - State:TX
Mailing Address - Zip Code:75234-1355
Mailing Address - Country:US
Mailing Address - Phone:847-508-3231
Mailing Address - Fax:
Practice Address - Street 1:6300 W PARKER RD STE G24
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-8105
Practice Address - Country:US
Practice Address - Phone:972-378-0633
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-29
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX81686231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist