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Individual

DINA KELLY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
306 W MILL ST, CARBONDALE, IL 62901-2727
(618) 529-3060
Mailing address
1504 W TAYLOR DR, CARBONDALE, IL 62901-2222
(618) 525-4587

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
146.010191
IL

Other

Enumeration date
02/05/2015
Last updated
02/05/2015
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