IndividualActive
Mylisa Jacobson, CCC-SLP
NPI 1245980176 · Speech-Language Pathologist · Delta, UT
Provider details
- NPI number
- 1245980176
- Entity type
- Individual
- Primary specialty
- Speech-Language PathologistSpeech, Language and Hearing Service Providers
- Credential
- CCC-SLP
- Sex
- Female
- Sole proprietor
- No
- License
- 12638023-4102 (UT)
Specialties & taxonomies
Speech, Language and Hearing Service Providers
Practice location
95 White Sage Ave Ste C
Delta, UT 84624-5555
Phone: (435) 864-2551
Fax: (435) 864-3573
Approximate (ZIP-level) locationGet directions
Mailing address
95 White Sage Ave Ste C
Delta, UT 84624-5555
Registry dates
- Enumerated
- 2022-03-24
- Last updated
- 2022-03-24
- Certified
- 2022-03-24
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.