Individual
KAYLA FENNELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3035 CHERRY STREET, HOQUIAM, WA 98550
(360) 532-7882
Mailing address
1016 CHESTER AVE, GRAYLAND, WA 98547-9500
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
LL60478468
WA
Other
Enumeration date
03/20/2015
Last updated
03/20/2015
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