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Individual

KIMBERLY LYNN ELLRICH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MS, CCC-SLP

Contact information

Practice address
STORYPOINT, 3951 W MILHAM AVE, PORTAGE, MI 49024
(269) 329-0200
Mailing address
1035 MOHAWK HILLS DRIVE, APT D, CARMEL, IN 46032
(765) 366-1587

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
46002371A
IN
235Z00000X
Speech-Language Pathologist
Primary
7101006077
MI

Other

Enumeration date
09/12/2012
Last updated
10/17/2019
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