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1871996900
KELLY C IRVIN
BRADENTON, FL
NPI
1871996900
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Former Name
KELLY C SAMUELSON
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
235Z00000X Speech-Language Pathologist,
(Licence: FL SA10360)
Enumeration Date
2014-10-03
Last Update Date
2014-10-03
Business Address
-- KELLY C IRVIN SLP
3409 26TH ST W
BRADENTON, FL 34205-3600
Phone number: 941-751-7200
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Mailing Address
-- KELLY C IRVIN SLP
531 VISTA RIDGE DR
RUSKIN, FL 33570-2954
Phone number: 773-444-9045
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