Individual
KELLI SHYTLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1627 WURTS AVE, ASHLAND, KY 41101-4658
(606) 615-1190
Mailing address
1627 WURTS AVE, ASHLAND, KY 41101-4658
(606) 615-1190
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP23769
CA
Other
Enumeration date
10/29/2017
Last updated
10/29/2017
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