Individual
JAKE KENYON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
455 BRAYTON AVE, SOMERSET, MA 02726-2642
(508) 679-2240
Mailing address
58 EUCLID AVE, QUINCY, MA 02169-1948
(774) 319-3708
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
9833
MA
Other
Enumeration date
06/03/2015
Last updated
09/19/2016
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