Individual
STACI MICHELLE KELLUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
951 FRONTAGE RD UNIT 34, OXFORD, MS 38655-5137
(662) 816-7989
Mailing address
951 FRONTAGE RD UNIT 34, OXFORD, MS 38655-5137
(662) 816-7989
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
S3769
MS
Other
Enumeration date
07/17/2013
Last updated
07/17/2013
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