Individual
KELLY RENEA DANIEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
305 N MAIN ST, ELIZABETHTOWN, KY 42701-1328
(270) 300-2601
Mailing address
305 N MAIN ST, ELIZABETHTOWN, KY 42701-1328
(270) 300-2601
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
167105
KY
Other
Enumeration date
01/22/2022
Last updated
01/22/2022
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