Individual
MRS. KIRSTEN CONELY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8578 SANDPIPER ST, CANTON, MI 48187-1708
(734) 751-6065
Mailing address
8578 SANDPIPER ST, CANTON, MI 48187-1708
(734) 751-6065
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
24668
CA
235Z00000X
Speech-Language Pathologist
Primary
7101001829
MI
235Z00000X
Speech-Language Pathologist
SL012790
PA
Other
Enumeration date
08/16/2016
Last updated
08/16/2016
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