Individual
KEELY JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
8402 SIX FORKS RD STE 101, RALEIGH, NC 27615-3071
(919) 847-6773
Mailing address
8402 SIX FORKS RD STE 101, RALEIGH, NC 27615-3071
(919) 847-6773
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
8580
NC
Other
Enumeration date
03/17/2010
Last updated
03/17/2010
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