| NPI | 1265789556 |
|---|---|
| Former Name | KELLY E TALLEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: MS S2001) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: AL 3529) |
| Enumeration Date | 2012-08-06 |
| Last Update Date | 2013-08-28 |