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Individual

MRS. JADE YVONNE KELLY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.ED, CCC-SLP

Contact information

Practice address
1152 TIFTON ELDORADO RD, TIFTON, GA 31794-8729
(478) 455-1171
(229) 329-4532
Mailing address
817 GEORGIA DR, TIFTON, GA 31794-4215
(229) 402-2614

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP005980
GA

Other

Enumeration date
03/08/2018
Last updated
03/08/2018
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