Individual
KELLI ANNE KING CHARLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S. CCC-SLP
Contact information
Practice address
336 W 3700 N, PROVO, UT 84604-4956
(385) 208-3722
Mailing address
336 W 3700 N, PROVO, UT 84604-4956
(385) 208-3722
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
720322
UT
Other
Enumeration date
04/30/2026
Last updated
04/30/2026
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