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Individual
MS. KEMBERLEE J JACK
Active
Individual
MS. KEMBERLEE J JACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
35825
TX
235Z00000X
Speech-Language Pathologist
Primary
115500
TX
235Z00000X
Speech-Language Pathologist
8201
LA
235Z00000X
Speech-Language Pathologist
SLP010119
GA
Other
Enumeration date
03/31/2011
Last updated
05/11/2021
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