Individual
KELLY JENKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PEER SUPPORTER
Contact information
Practice address
425 MARION PIKE, COAL GROVE, OH 45638-2960
(740) 646-6640
Mailing address
425 MARION PIKE, COAL GROVE, OH 45638-2960
(740) 646-6640
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
10/28/2022
Last updated
10/28/2022
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