Individual
MS. CORNETA E. KELLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A.,CCC-SLP
Contact information
Practice address
1201 E FRY BLVD, SUITE #5, SIERRA VISTA, AZ 85635-2600
(520) 459-8258
(520) 459-8619
Mailing address
2160 E FRY BLVD # 310, SIERRA VISTA, AZ 85635-2736
(520) 459-8258
(520) 459-8619
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP4673
AZ
235Z00000X
Speech-Language Pathologist
SP 11835
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
968109
AHCCCS
AZ
Enumeration date
10/23/2006
Last updated
07/08/2007
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