Individual
MS. KELLI NICOLE HUMBERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
626 E SLIFER ST, CESA 5, PORTAGE, WI 53901-1224
(608) 745-5400
Mailing address
306 LILAC LN, HOLMEN, WI 54636-7315
(815) 326-1539
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
4603-154
WI
Other
Enumeration date
07/14/2014
Last updated
12/23/2014
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