Individual
MRS. KELLY KONGVOLD-GLASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
14 BRIDGEWATERS DR STE A, OCEANPORT, NJ 07757-1184
(732) 542-6600
(732) 542-6606
Mailing address
14 BRIDGEWATERS DR STE A, OCEANPORT, NJ 07757-1184
(732) 542-6600
(732) 542-6606
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
016527-1
NY
235Z00000X
Speech-Language Pathologist
Primary
41YS00578000
NJ
Other
Enumeration date
10/30/2008
Last updated
09/15/2010
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