Provider Demographics
NPI:1699017053
Name:SOCOP, JACQUELINE M (MS, CCC-SLP)
Entity type:Individual
Prefix:MISS
First Name:JACQUELINE
Middle Name:M
Last Name:SOCOP
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 1:1260 PIN OAK RD STE 108
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-5603
Mailing Address - Country:US
Mailing Address - Phone:281-395-5599
Mailing Address - Fax:
Practice Address - Street 1:1260 PIN OAK RD STE 108
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-5603
Practice Address - Country:US
Practice Address - Phone:281-395-5599
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-25
Last Update Date:2013-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX107291235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX107291OtherSTATE BOARD OF EXAMINERS FOR SPEECH-LANGUAGE PATHOLOGY AND AUDIOLOGY