Individual
JENNY ELLISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
200 ONE NINETEEN BLVD, BIRMINGHAM, AL 35242-7236
(800) 401-6335
Mailing address
2094 CHELSEA RIDGE DR, COLUMBIANA, AL 35051-3380
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2363
AL
Other
Enumeration date
10/21/2018
Last updated
10/21/2018
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