Individual
MRS. KELLIE ELIZABETH GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A., CCC-SLP, IBCLC
Contact information
Practice address
3600 OLENTANGY RIVER RD, BLDG D, STE 107, COLUMBUS, OH 43214-3437
(614) 974-2211
Mailing address
3173 WINDING WOODS DR, POWELL, OH 43065-8180
(614) 342-0610
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
Primary
L-310957
OH
235Z00000X
Speech-Language Pathologist
SP.9217
OH
Other
Enumeration date
01/02/2009
Last updated
11/28/2023
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