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Organization
KOR SPEECH THERAPY, LLC
Active
Organization
KOR SPEECH THERAPY, LLC
Active
Other names
Stacey Killeen
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. STACEY LYNN KILLEEN M.A. CCC-SLP (SPEECH-LANGUAGE PATHOLOGIST)
(219) 742-1400
Entity
Organization
Contact information
Practice address
219 PRIMROSE DR., DYER, IN 46311
(219) 742-1400
(219) 809-2674
Mailing address
219 PRIMROSE DR., DYER, IN 46311
(219) 742-1400
(219) 809-2674
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
146006920
IL
235Z00000X
Speech-Language Pathologist
Primary
22005278A
IN
Other
Enumeration date
09/20/2017
Last updated
09/20/2017
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