Individual
KELLIE W TALLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.ED, CCC-SLP
Contact information
Practice address
2068 SUMMIT WAY, EAGLE MOUNTAIN, UT 84005-2089
(801) 879-5886
Mailing address
2068 SUMMIT WAY, EAGLE MOUNTAIN, UT 84005-2089
(801) 879-5886
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
7873775-4102
UT
Other
Enumeration date
03/25/2011
Last updated
03/25/2011
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