Individual
MRS. KELLY MARIE ORYSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS CCC- SLP
Contact information
Practice address
103 S GIBSON ST, MEDFORD, WI 54451-1622
(715) 748-8112
(715) 748-8792
Mailing address
103 S GIBSON ST, MEDFORD, WI 54451-1622
(715) 748-8112
(715) 748-8792
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2961154
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42586500
—
WI
Enumeration date
11/27/2007
Last updated
07/07/2009
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