Individual
COLLEEN JENKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP006097
Contact information
Practice address
1200 LAKE HEARN DR NE, SUITE 250, ATLANTA, GA 30319-1415
(404) 943-1070
(404) 943-0890
Mailing address
120 WABURN WALK, DALLAS, GA 30132-2391
(404) 421-3200
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP006097
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
698890714A
—
GA
Enumeration date
10/16/2006
Last updated
07/08/2007
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