Individual
KELLY FISH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1040 SCHOOL ST, VEAZIE, ME 04401-6950
(207) 947-6573
Mailing address
1040 SCHOOL ST, VEAZIE, ME 04401-6950
(207) 947-6573
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP1085
ME
Other
Enumeration date
09/01/2010
Last updated
09/01/2010
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