Individual
KATIE ALYSSA JENKINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2704 N OAK ST BLDG A2, VALDOSTA, GA 31602-5900
(229) 253-1009
(229) 253-1039
Mailing address
2704 N OAK ST BLDG A2, VALDOSTA, GA 31602-5900
(229) 253-1009
(229) 253-1039
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
PCET002847
GA
Other
Enumeration date
10/03/2019
Last updated
10/03/2019
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