Individual
KELLAN ALISE MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSCFSLP
Contact information
Practice address
204 JEFFERSON AVENUE, GRANT COUNTY BOARD OF EDUCATION, PETERSBURG, WV 26847
(304) 267-3595
(304) 267-3599
Mailing address
204 JEFFERSON AVENUE, GRANT COUNTY BOARD OF EDUCATION, PETERSBURG, WV 26847
(304) 267-3595
(304) 267-3599
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
7085
WV
Other
Enumeration date
12/20/2010
Last updated
12/20/2010
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