| Doctor Name: | MS. KELLY JEAN MASON |
| NPI Number: | 1538462270 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | SLPA |
| License Number: | |
| Business Practice Address: | 6 1/2 Beech St East Millinocket, ME - 044301152 |
| Business Phone Number: | 2077463520 |
| Business Fax Number: | |
| Mailing Address: | 6 1/2 Beech St, EAST MILLINOCKET |
| State: | ME |
| Postal Code: | 044301152 |
| Phone Number: | 2077463520 |
| Fax Number: | |
| NPI Enumeration Date: | 12/20/2010 |
| NPI Last Update Date: | 12/20/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2355S0801X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Specialist/Technologist |
| Taxonomy Specialization: | Speech-Language Assistant |
| Taxonomy Definition: | |