Individual
KELLY GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
815 TRIPLETT ST, OWENSBORO, KY 42303-3564
(270) 683-4517
Mailing address
815 TRIPLETT ST, OWENSBORO, KY 42303-3564
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2307
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
11903135
—
KY
05
—
45118379
—
KY
Enumeration date
02/25/2015
Last updated
02/25/2015
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