KELLI BANTA

HATTIESBURG, MS
NPI1003591769
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy235Z00000X Speech-Language Pathologist,
Enumeration Date2023-06-20
Last Update Date2023-06-20
Business Address
KELLI BANTA
4805 W 4TH ST
HATTIESBURG, MS 39402-1019
Phone number: 601-270-6968
Mailing Address
KELLI BANTA
606 CONCART ST
HATTIESBURG, MS 39401-4213
Phone number: 504-701-4709
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