Individual
MRS. AUDREY JILL KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5908 BLACKLEY LN, INDIANAPOLIS, IN 46254-6101
(317) 514-5365
Mailing address
5908 BLACKLEY LN, INDIANAPOLIS, IN 46254-6101
(317) 514-5365
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
22004633A
IN
Other
Enumeration date
05/18/2009
Last updated
05/18/2009
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