Individual
KELLY DALE GREGORY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS CCC-SLP
Contact information
Practice address
1011 PORTERS NECK RD, WILMINGTON, NC 28411-9196
(910) 319-2119
Mailing address
7300 VESPAR CT, WILMINGTON, NC 28411-7355
(814) 316-1353
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
8941
NC
Other
Enumeration date
06/07/2011
Last updated
07/06/2012
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