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Individual

JACOB WALKER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CCC-SLP

Contact information

Practice address
980 MORGANTOWN RD, BOWLING GREEN, KY 42101-3644
(270) 495-1312
(270) 495-1351
Mailing address
944 FIELDS DR STE 102, BOWLING GREEN, KY 42104-5341
(270) 495-1312

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
173818
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
242920
KENTUCKY SPEECH-LANGUAGE PATHOLOGY LICENSURE
KY
Enumeration date
07/26/2017
Last updated
09/14/2022
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