Individual
KELLY MEATHE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12901 N 63RD AVE, GLENDALE, AZ 85304-1701
(623) 412-4750
Mailing address
12901 N 63RD AVE, GLENDALE, AZ 85304-1701
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
TSLP10674
AZ
Other
Enumeration date
09/05/2017
Last updated
09/05/2017
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