Individual
JESSICA KEEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1120 15TH ST, BIW-6045, AUGUSTA, GA 30912-0004
(706) 721-5223
Mailing address
1120 15TH ST, BIW-6045, AUGUSTA, GA 30912-0004
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP008509
GA
Other
Enumeration date
03/28/2016
Last updated
03/28/2016
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