Individual
KELLY CIEZCZAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
966 CHEROKEE CT, CROWN POINT, IN 46307-4613
(219) 671-0623
Mailing address
966 CHEROKEE CT, CROWN POINT, IN 46307-4613
(219) 671-0623
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
11718
NC
235Z00000X
Speech-Language Pathologist
22006267A
IN
235Z00000X
Speech-Language Pathologist
Primary
SP-9837-SL
MA
Other
Enumeration date
08/16/2016
Last updated
03/24/2025
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