Individual
KELLI KIDD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS,CCC-SLP
Contact information
Practice address
2804 GREENHILL BLVD NW, SUITE 102, FORT PAYNE, AL 35968-3066
(256) 979-1222
(256) 979-1223
Mailing address
2804 GREENHILL BLVD NW, SUITE 102, FORT PAYNE, AL 35968-3066
(256) 979-1222
(256) 979-1223
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3375
AL
Other
Enumeration date
03/23/2015
Last updated
03/23/2015
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