Individual
MISS CAILYN ELIZABETH KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AUD, CCC-A
Contact information
Practice address
500 CONGRESS ST STE 2J, QUINCY, MA 02169-0960
(617) 479-7503
Mailing address
DEPT 3298, CAROL STREAM, IL 60132-3298
(617) 479-7503
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
877
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5107041
—
MA
Enumeration date
10/30/2007
Last updated
09/20/2012
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