| NPI | 1881185163 |
|---|---|
| Former Name | KELLY LYNN POLACHECK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist (Licence: FL SA13587) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist (Licence: PA SL010732) |
| Enumeration Date | 2018-05-23 |
| Last Update Date | 2020-08-10 |