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Individual

KELLY LEE COLCLASURE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS CCC-SLP

Contact information

Practice address
3380 E MAIN ST, DANVILLE, IN 46122-9089
(317) 178-0089
(317) 718-0097
Mailing address
5814 EAST COUNTY ROAD 100 NORTH, AVON, IN 46123
(317) 745-4739

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
22004397A
IN

Other

Enumeration date
03/13/2007
Last updated
07/09/2007
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