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Individual

MRS. CLEMENTINA LEE CONNOLLY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MS ,CCC-SLP

Contact information

Practice address
2001 SCENIC DR, GEORGETOWN, TX 78626-7725
(512) 863-9511
Mailing address
104 RIO VISTA CV, GEORGETOWN, TX 78626-4529

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
104050
TX

Other

Enumeration date
08/22/2018
Last updated
08/22/2018
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