NPI | 1912292723 |
---|---|
Former Name | KELLY LYNN REED |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: 12134217) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: MI 71010000745) |
Enumeration Date | 2011-06-09 |
Last Update Date | 2021-02-03 |