Individual
KELLY ROLLET
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
610 W NASH ST, WILSON, NC 27893-3045
(252) 293-0739
Mailing address
PO BOX 8003, WILSON, NC 27893-1003
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2569
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
74605
BCBS
NC
05
—
7474605
—
NC
Enumeration date
05/02/2007
Last updated
07/09/2007
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