| Doctor Name: | MARCIE KELLY |
| NPI Number: | 1467625061 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.ED.,CCC-SLP |
| License Number: | SLP-A 0064 |
| Business Practice Address: | 1189 Kader Merritt Road Rose Hill, NC - 28458 |
| Business Phone Number: | 9105326300 |
| Business Fax Number: | 9105326350 |
| Mailing Address: | 180 Stonewall Kelly Lane, CLINTON |
| State: | NC |
| Postal Code: | 28328 |
| Phone Number: | 9103798400 |
| Fax Number: | 9102990800 |
| NPI Enumeration Date: | 04/04/2008 |
| NPI Last Update Date: | 09/11/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2355S0801X |
| License Number: | SLP-A 0064 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NC |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Specialist/Technologist |
| Taxonomy Specialization: | Speech-Language Assistant |
| Taxonomy Definition: | |