Individual
CHARLEEN A KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, CCCSLP, PHD
Contact information
Practice address
402 91ST AVE NE, LAKE STEVENS, WA 98258-2530
(425) 334-4071
Mailing address
402 91ST AVE NE, LAKE STEVENS, WA 98258-2530
(425) 334-4071
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
LL00002598
WA
Other
Enumeration date
04/25/2008
Last updated
04/25/2008
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