Mylisa Jacobson, CCC-SLP | |
95 White Sage Ave Ste C, Delta, UT 84624-5555 | |
(435) 864-2551 | |
(435) 864-3573 |
Full Name | Mylisa Jacobson |
---|---|
Gender | Female |
Speciality | Speech-language Pathologist |
Location | 95 White Sage Ave Ste C, Delta, Utah |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1245980176 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
235Z00000X | Speech-language Pathologist | 12638023-4102 (Utah) | Primary |
Provider Name | Delta Physical Therapy And Sports Medicine Pc |
---|---|
Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1801834700 PECOS PAC ID: 0941101372 Enrollment ID: O20040117000230 |
Mailing Address | Practice Location Address |
---|---|
Mylisa Jacobson, CCC-SLP 95 White Sage Ave Ste C, Delta, UT 84624-5555 Ph: (435) 864-2551 | Mylisa Jacobson, CCC-SLP 95 White Sage Ave Ste C, Delta, UT 84624-5555 Ph: (435) 864-2551 |
Katy Glenn Roper, SLP Speech-Language Pathologist Medicare: Accepting Medicare Assignments Practice Location: 95 White Sage Ave Ste C, Delta, UT 84624 Phone: 435-864-2551 | |
Mrs. Andrea Kay Young, M.S. CCC-SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 1237 S 2000 W, Delta, UT 84624 Phone: 775-622-7488 | |
Shari Winters, Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 126 White Sage Ave, Delta, UT 84624 Phone: 435-864-5591 |