Individual
JENNA KIRK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SP
Contact information
Practice address
4400 MARKETING PL STE B, GROVEPORT, OH 43125-9308
(614) 492-2520
Mailing address
10063 ALLEN RD, PICKERINGTON, OH 43147-9404
(740) 412-7764
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP.10069
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0094740
—
OH
01
—
SP.10069
SPEECH PATHOLOGY BOARD
OH
Enumeration date
04/04/2012
Last updated
08/22/2024
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