Individual
KELLY REARDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2213 N CAMPUS AVE, UPLAND, CA 91784-1372
(909) 618-6007
Mailing address
2213 N CAMPUS AVE, UPLAND, CA 91784-1372
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
SPA2088
CA
Other
Enumeration date
11/07/2013
Last updated
11/07/2013
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