Individual
JENNA KAY MORTENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2086 7TH STREET, CHARLESTON, IL 61920
(217) 581-2712
Mailing address
205 W SEMINOLE ST, DWIGHT, IL 60420-1153
(815) 992-9772
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
06/09/2020
Last updated
06/09/2020
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