Individual
MICHAEL JOHN KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS, CCC-SLP
Contact information
Practice address
1015 GRIDER POND RD, BOWLING GREEN, KY 42104-4615
(270) 779-5257
Mailing address
3484 FAIR OAKS AVE, BOWLING GREEN, KY 42104-5529
(270) 779-5257
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
162605
KY
Other
Enumeration date
05/05/2016
Last updated
03/06/2024
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