Individual
KELLY W. ROBERTSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4228 GRAND MARAIS RD, JENNINGS, LA 70546-8273
(337) 288-9418
Mailing address
4228 GRAND MARAIS RD, JENNINGS, LA 70546-8273
(337) 288-9418
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
4897
LA
Other
Enumeration date
09/11/2008
Last updated
09/11/2008
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