Individual
MRS. JAYNA NICHOLE WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S. CCC-SLP
Contact information
Practice address
1381 CAMPBELL LN, BOWLING GREEN, KY 42104-1049
(270) 843-0587
Mailing address
239 W MCLELLAN RD, BOWLING GREEN, KY 42101-8891
(270) 784-7690
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
142455
KY
Other
Enumeration date
12/04/2017
Last updated
12/04/2017
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