Individual
JILL C MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
601 CRAWFORD ST, KELSO, WA 98626-4315
(503) 750-5055
Mailing address
601 CRAWFORD ST, KELSO, WA 98626-4315
(503) 750-0555
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
LL61103904
WA
Other
Enumeration date
10/09/2020
Last updated
10/09/2020
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