Individual
MS. CHRISTINE SANDERS KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
212 NORTH COURT STREET, WAYNE, WV 25570
(304) 272-5116
(304) 272-5993
Mailing address
484 MAIN STREET, CEREDO, WV 25507
(304) 272-5116
(304) 272-5993
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP-2310
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810013621
—
WV
Enumeration date
03/09/2009
Last updated
03/09/2009
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