Provider Demographics
NPI:1700294246
Name:KEMP, JACQUELIN (MSCCCSLP)
Entity Type:Individual
Prefix:MRS
First Name:JACQUELIN
Middle Name:
Last Name:KEMP
Suffix:
Gender:F
Credentials:MSCCCSLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 CORPORATE CENTER DR
Mailing Address - Street 2:
Mailing Address - City:MANALAPAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07726-8736
Mailing Address - Country:US
Mailing Address - Phone:732-761-0302
Mailing Address - Fax:732-761-0305
Practice Address - Street 1:300 CORPORATE CENTER DR
Practice Address - Street 2:
Practice Address - City:MANALAPAN
Practice Address - State:NJ
Practice Address - Zip Code:07726-8736
Practice Address - Country:US
Practice Address - Phone:732-761-0302
Practice Address - Fax:732-761-0305
Is Sole Proprietor?:No
Enumeration Date:2014-07-29
Last Update Date:2014-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00348600235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist