Individual
CHARISSA GENE KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA CFY/SLP
Contact information
Practice address
303 SECOND ST, SOMERSET, KY 42501-2390
(606) 677-1166
(606) 677-0693
Mailing address
515 HIGHWAY 3091, SOMERSET, KY 42503-5745
(606) 677-1166
(606) 677-0693
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
174282
KY
235Z00000X
Speech-Language Pathologist
Primary
243267
KY
235Z00000X
Speech-Language Pathologist
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Other
Enumeration date
08/24/2017
Last updated
12/07/2018
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