Individual
MS. MICHELE Y. KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
1301 27TH ST SE, RIO RANCHO, NM 87124-5201
(505) 892-2575
Mailing address
500 LASER DR NE, RIO RANCHO, NM 87124-4517
(505) 892-2575
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1539
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000Z3223
—
NM
Enumeration date
02/26/2007
Last updated
07/08/2007
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