Individual
MRS. AMANDA WEATHERS KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.,CCC-SLP
Contact information
Practice address
120 OSLO CIR, BIRMINGHAM, AL 35211-5965
(205) 944-3980
(205) 944-3990
Mailing address
20880 SHARON DR, MC CALLA, AL 35111-1332
(205) 218-0249
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2214
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51525706
BCBS NUMBER
AL
05
—
890012710
—
AL
Enumeration date
08/31/2006
Last updated
03/24/2008
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