Individual
MRS. JACQUELINE KAY KENYON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S. CCC-SLP
Contact information
Practice address
3555 E FRY BLVD, SIERRA VISTA, AZ 85635-2972
(520) 515-2790
Mailing address
3555 EAST FRY BOULEVARD, SIERRA VISTA, AZ 85635
(520) 515-2790
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
6951
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
#SLP6951
—
AZ
Enumeration date
12/21/2010
Last updated
12/21/2010
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