Provider Demographics
NPI:1891151924
Name:GARNER, JACLYN ELKINS (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:JACLYN
Middle Name:ELKINS
Last Name:GARNER
Suffix:
Gender:F
Credentials:MS, CCC-SLP
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Mailing Address - Street 1:1610 CENTER ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36604-1512
Mailing Address - Country:US
Mailing Address - Phone:251-415-1670
Mailing Address - Fax:251-415-1671
Practice Address - Street 1:1610 CENTER ST
Practice Address - Street 2:SUITE B
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36604-1512
Practice Address - Country:US
Practice Address - Phone:251-415-1670
Practice Address - Fax:251-415-1671
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-05
Last Update Date:2016-01-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AL3612235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist