Individual
JENNIFER MELLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1252 W DIVERSEY PKWY APT 1, CHICAGO, IL 60614-1285
(248) 425-1519
Mailing address
1252 W DIVERSEY PKWY APT 1, CHICAGO, IL 60614-1285
(248) 425-1519
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
242004305
IL
Other
Enumeration date
01/11/2017
Last updated
01/11/2017
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