Individual
JENNA MARCUM BLYTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
204 RING RD, LOUISVILLE, KY 40207
(502) 439-1552
Mailing address
204 RING RD, LOUISVILLE, KY 40207
(502) 439-1552
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
22005289A
IN
235Z00000X
Speech-Language Pathologist
Primary
3898
KY
Other
Enumeration date
09/02/2011
Last updated
12/12/2013
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