Individual
KIM RAE JOLIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A., CCC/SLP
Contact information
Practice address
111 DODGE ST, 111 DODGE STREET, BEVERLY, MA 01915-1827
(978) 921-1182
Mailing address
111 DODGE ST, 111 DODGE STREET, BEVERLY, MA 01915-1827
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2308
MA
Other
Enumeration date
02/25/2008
Last updated
02/25/2008
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