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Individual

KELLY RENEE JACOBS- BELODEAU

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
47774 BRAWNER PL, POTOMAC FALLS, VA 20165-4708
(703) 629-9248
Mailing address
47774 BRAWNER PL, POTOMAC FALLS, VA 20165-4708
(703) 629-9248

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
19679
CA
235Z00000X
Speech-Language Pathologist
2202004176
VA

Other

Enumeration date
08/17/2016
Last updated
08/17/2016
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