| Doctor Name: | KELLY LEE COLCLASURE |
| NPI Number: | 1578696399 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MS CCC-SLP |
| License Number: | 22004397A |
| Business Practice Address: | 3380 E Main St Danville, IN - 461229089 |
| Business Phone Number: | 3171780089 |
| Business Fax Number: | 3177180097 |
| Mailing Address: | 5814 East County Road 100 North, AVON |
| State: | IN |
| Postal Code: | 46123 |
| Phone Number: | 3177454739 |
| Fax Number: | |
| NPI Enumeration Date: | 03/13/2007 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 22004397A |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IN |
| 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 |