Individual
KELLY OWENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
789 STONEYBROOK TRL, FAIRBORN, OH 45324-6021
(937) 878-0262
Mailing address
789 STONEYBROOK TRL, FAIRBORN, OH 45324-6021
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
8528
OH
Other
Enumeration date
12/16/2016
Last updated
12/16/2016
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