Organization
KELLY MOLLISON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAREN KELLY MOLLISON MS CCC SLP (OWNER)
(602) 527-4829
Entity
Organization
Contact information
Practice address
4602 E SUNSET DR, PHOENIX, AZ 85028-6115
(602) 527-4829
(480) 483-1026
Mailing address
4602 E SUNSET DR, PHOENIX, AZ 85028-6115
(602) 527-4829
(480) 483-1026
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
0584
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
801474
—
AZ
Enumeration date
09/04/2009
Last updated
09/04/2009
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