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Individual
JENNIFER KELLAMS
Active
Individual
JENNIFER KELLAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
22005722
IN
235Z00000X
Speech-Language Pathologist
LL 60507504
WA
235Z00000X
Speech-Language Pathologist
SP 22380
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
22005722
INDIANA PUBLIC LICENSING AGENCY, SPEECH-LANGUAGE PATHOLOGY
IN
01
—
LL 60507504
DEPARTMENT OF HEALTH, WASHINGTON STATE
WA
01
—
SP 22380
SPEECH LANGUAGE PATHOLOGY & AUDIOLOGY & HEARING AID DISPENSERS BOARD
CA
Enumeration date
12/02/2014
Last updated
12/02/2014
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