Individual
KELLY SPENCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
25112 HIGHWAY 15, UNION, MS 39365-8580
(601) 774-0444
Mailing address
405 GARRISON RD, DECATUR, MS 39327-9266
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
S3003
MS
Other
Enumeration date
10/17/2008
Last updated
10/17/2008
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