Individual
KELLEY MARIE JIMENEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11 DAIRY LN, FREDERICKSBURG, VA 22405-2663
(540) 371-9414
Mailing address
11 DAIRY LN, FREDERICKSBURG, VA 22405-2663
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2202010841
VA
Other
Enumeration date
11/03/2016
Last updated
02/27/2024
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