Individual
STEPHANIE NICOLE JENKINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA CCC-SLP
Contact information
Practice address
115 PECAN RIDGE DR, FAYETTEVILLE, GA 30215-6863
(614) 440-5002
(470) 488-0797
Mailing address
115 PECAN RIDGE DR, FAYETTEVILLE, GA 30215-6863
(614) 440-5002
(470) 488-0797
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
011235
GA
Other
Enumeration date
08/16/2021
Last updated
08/16/2021
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