Provider Demographics
NPI:1790293629
Name:FOELGNER JONES, KERRY DENE (MA CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:KERRY
Middle Name:DENE
Last Name:FOELGNER JONES
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:232 N 53RD AVENUE CT
Mailing Address - Street 2:
Mailing Address - City:GREELEY
Mailing Address - State:CO
Mailing Address - Zip Code:80634-4258
Mailing Address - Country:US
Mailing Address - Phone:970-324-9375
Mailing Address - Fax:
Practice Address - Street 1:232 N 53RD AVENUE CT
Practice Address - Street 2:
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80634-4258
Practice Address - Country:US
Practice Address - Phone:970-324-9375
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-12
Last Update Date:2018-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COSLP.0000908235Z00000X
COSLP0000908235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty