Provider Demographics
NPI:1225653561
Name:JONES, KELLY ANNE (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:ANNE
Last Name:JONES
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 E. MEDICAL CENTER DR.
Mailing Address - Street 2:UH SPEECH-LANGUAGE PATHOLOGY, 1D203 UH
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48109
Mailing Address - Country:US
Mailing Address - Phone:586-540-7132
Mailing Address - Fax:734-615-1532
Practice Address - Street 1:1500 E. MEDICAL CENTER DR.
Practice Address - Street 2:UH SPEECH-LANGUAGE PATHOLOGY, 1D203 UH
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48109
Practice Address - Country:US
Practice Address - Phone:586-540-7132
Practice Address - Fax:734-615-1532
Is Sole Proprietor?:No
Enumeration Date:2020-06-12
Last Update Date:2020-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI7151000344235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist