Individual
KENSEY KELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1115 WILLS WAY, DANVILLE, IN 46122-7200
(317) 714-0726
Mailing address
1115 WILLS WAY, DANVILLE, IN 46122-7200
(317) 714-0726
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
22005009A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
22005009A
SPEECH PATHOLOGIST
IN
Enumeration date
06/02/2010
Last updated
07/29/2014
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