Organization
KOR SPEECH THERAPY, LLC
Active
Other names
Stacey Killeen
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. STACEY LYNN KILLEEN M.A. CCC-SLP (SPEECH-LANGUAGE PATHOLOGIST)
(219) 742-1400
Entity
Organization
Contact information
Practice address
219 PRIMROSE DR., DYER, IN 46311
(219) 742-1400
(219) 809-2674
Mailing address
219 PRIMROSE DR., DYER, IN 46311
(219) 742-1400
(219) 809-2674
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
146006920
IL
235Z00000X
Speech-Language Pathologist
Primary
22005278A
IN
Other
Enumeration date
09/20/2017
Last updated
09/20/2017
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