Individual
MS. ALEXANNE KENNEDY CONKLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS.CCC/SLP
Contact information
Practice address
185 SOUTH MOUNTAIN BLVD, MOUNTAIN TOP, PA 18707
(570) 474-6377
(570) 474-2109
Mailing address
PO BOX 240, 8796 ROUTE 219, BROCKWAY, PA 15824
(814) 265-7874
(814) 265-2082
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SL-002762-L
PA
Other
Enumeration date
06/21/2012
Last updated
06/21/2012
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