Individual
PROF. ELLEN M. KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
1215 21ST AVE S STE 6358, NASHVILLE, TN 37232-0014
(615) 936-5174
(615) 875-1411
Mailing address
1215 21ST AVE S STE 6358, NASHVILLE, TN 37232-0014
(615) 936-5174
(615) 875-1411
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3699
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01042969
ASHA CCC-SLP
—
01
—
3699
TN STATE LICENSE SLP
TN
Enumeration date
04/15/2019
Last updated
06/11/2019
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