Provider Demographics
NPI:1376677690
Name:JAMES, KELLI MAUREEN
Entity Type:Individual
Prefix:
First Name:KELLI
Middle Name:MAUREEN
Last Name:JAMES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13520 ASHBURY DR
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-8225
Mailing Address - Country:US
Mailing Address - Phone:317-810-9472
Mailing Address - Fax:317-846-9484
Practice Address - Street 1:13520 ASHBURY DR
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-8225
Practice Address - Country:US
Practice Address - Phone:317-810-9472
Practice Address - Fax:317-846-9484
Is Sole Proprietor?:No
Enumeration Date:2007-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN22003235A235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist