| NPI | 1518476639 |
|---|---|
| Doing Business As | STACEY KILLEEN |
| Entity Type | Organization |
| Authorized Contact | STACEY LYNN KILLEEN Speech Language Pathologist 219-742-1400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: IN 22005278A) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: IL 146006920) |
| Enumeration Date | 2017-09-20 |
| Last Update Date | 2017-09-20 |