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Individual

MISS KELLY POOL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MA, CCC-SLP

Contact information

Practice address
9011 CHEVROLET DR, ELLICOTT CITY, MD 21042-4024
(443) 325-5542
Mailing address
9011 CHEVROLET DR, ELLICOTT CITY, MD 21042-4024
(443) 325-5542

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
01806
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01806
SPEECH LANGUAGE PATHOLOGY
MD
Enumeration date
12/06/2019
Last updated
12/06/2019
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