Individual
MRS. JACQUELINE KELLY EHLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
7855 TRAPPE RD, BALTIMORE, MD 21222-2347
(443) 809-7038
Mailing address
7855 TRAPPE RD, BALTIMORE, MD 21222-2347
(443) 809-7038
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
06377
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1508250879
—
MD
Enumeration date
03/25/2015
Last updated
05/13/2019
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