Provider Demographics
NPI:1801394093
Name:JACKSON, APRIL (MS CCC-SLP)
Entity type:Individual
Prefix:
First Name:APRIL
Middle Name:
Last Name:JACKSON
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22535 LAVACA RANCH LN
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77449-4895
Mailing Address - Country:US
Mailing Address - Phone:832-942-8352
Mailing Address - Fax:
Practice Address - Street 1:22535 LAVACA RANCH LN
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77449-4895
Practice Address - Country:US
Practice Address - Phone:832-942-8352
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-23
Last Update Date:2024-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COSLP.0006164235Z00000X
GASLP013332235Z00000X
TX112878235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist