Individual
JASMIN KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
110 IRVIN AVE SW, LIVE OAK, FL 32064-2214
(386) 362-3231
Mailing address
6716 JOY ST, MILTON, FL 32583-9037
(229) 726-3906
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
SI4549
FL
Other
Enumeration date
11/10/2020
Last updated
11/10/2020
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