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1689457129
KELLY POLK
SOUTHGATE, MI
NPI
1689457129
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
235Z00000X Speech-Language Pathologist,
(Licence: MI 7101002597)
Enumeration Date
2023-08-17
Last Update Date
2023-08-17
Business Address
KELLY POLK MA CCC-SLP
13331 REECK CT STE 201
SOUTHGATE, MI 48195-3054
Phone number: 734-675-3908
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Mailing Address
KELLY POLK MA CCC-SLP
23601 STERLING PL
DEARBORN, MI 48124-1632
Phone number:
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