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Individual

KELLY BAIERL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS, CCC-SLP

Contact information

Practice address
2145 TIBBETTS DR STE A, LONGVIEW, WA 98632-4211
(360) 560-1972
Mailing address
2145 TIBBETTS DR STE A, LONGVIEW, WA 98632-4211
(360) 560-1972
(360) 703-3452

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
60758912
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
14174246
ASHA
Enumeration date
05/21/2018
Last updated
05/21/2018
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