| Doctor Name: | MS. CORNETA E. KELLEY |
| NPI Number: | 1538242367 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.A.,CCC-SLP |
| License Number: | SP 11835 |
| Business Practice Address: | 1201 E Fry Blvd Suite #5 Sierra Vista, AZ - 856352600 |
| Business Phone Number: | 5204598258 |
| Business Fax Number: | 5204598619 |
| Mailing Address: | 2160 E Fry Blvd # 310, SIERRA VISTA |
| State: | AZ |
| Postal Code: | 856352736 |
| Phone Number: | 5204598258 |
| Fax Number: | 5204598619 |
| NPI Enumeration Date: | 10/23/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | SP 11835 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CA |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |