Individual
JENNIFER CULLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2608 FIELDSTONE DR, MARYVILLE, IL 62062-6433
(618) 363-9675
Mailing address
2608 FIELDSTONE DR, MARYVILLE, IL 62062-6433
(618) 363-9675
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
0325431
MO
235Z00000X
Speech-Language Pathologist
Primary
146.006564
IL
235Z00000X
Speech-Language Pathologist
SP 20740
CA
Other
Enumeration date
11/03/2015
Last updated
11/03/2015
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