Individual
MS. KELLY A PETERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
1579 E 85TH AVE, MERRILLVILLE, IN 46410-8901
(219) 525-4973
Mailing address
11517 HANLEY ST, CROWN POINT, IN 46307-8731
(219) 405-3244
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
220004869A
IN
Other
Enumeration date
08/06/2009
Last updated
08/15/2019
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