Individual
KELLY POLK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA CCC-SLP
Contact information
Practice address
13331 REECK CT STE 201, SOUTHGATE, MI 48195-3054
(734) 675-3908
(734) 675-3925
Mailing address
23601 STERLING PL, DEARBORN, MI 48124-1632
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
7101002597
MI
Other
Enumeration date
08/17/2023
Last updated
08/17/2023
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