Individual
KELLY-ANN PETERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS CCC-SLP, CLC
Contact information
Practice address
2017 NET WAY NW, BEMIDJI, MN 56601-5147
(218) 333-6347
Mailing address
1689 FOREST LN SE, BEMIDJI, MN 56601-8929
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
122408
IA
235Z00000X
Speech-Language Pathologist
Primary
528540
MN
Other
Enumeration date
09/20/2023
Last updated
05/21/2026
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