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1578896460
KELLY MACK
BOULDER, CO
NPI
1578896460
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
235Z00000X Speech-Language Pathologist,
(Licence: CA 15946)
Enumeration Date
2009-09-10
Last Update Date
2011-08-06
Business Address
-- KELLY MACK SLP
2124 16TH ST
BOULDER, CO 80302-4354
Phone number: 530-230-7429
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Mailing Address
-- KELLY MACK SLP
2124 16TH ST
BOULDER, CO 80302-4354
Phone number:
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