Individual
MRS. KELLIE ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, CCC-SLP
Contact information
Practice address
520 WOODLAND HLS, HARLAN, KY 40831-2565
(606) 574-0652
(606) 573-4030
Mailing address
520 WOODLAND HLS, HARLAN, KY 40831-2565
(606) 574-0652
(606) 573-4030
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
KY2930
KY
Other
Enumeration date
05/20/2007
Last updated
07/08/2007
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