Individual
MRS. KELLY D PETTIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A.CCC, SLP,L
Contact information
Practice address
14639 RIDGE RD, W SPRINGFIELD, PA 16443-1631
(814) 922-7378
(440) 293-5152
Mailing address
14639 RIDGE RD, W SPRINGFIELD, PA 16443-1631
(814) 922-7378
(440) 293-5152
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP 4858
OH
Other
Enumeration date
05/08/2007
Last updated
07/08/2007
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