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General NPI Number Information
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NPI Number | 1366969123
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Entity Type | Individual
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Provider Name | MRS. CHELSIE KIEL
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Gender | Female
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Dates
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Enumeration Date | 08/23/2017
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Last Update Date | 08/23/2017
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Provider Practice Location Address
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Address Line | 100 LINCOLN AVE
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City | JERSEYVILLE
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State | IL
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Zip | 62052-1473
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Country | US
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Telephone | 618-498-5561
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Fax |
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Provider Business Mailing Address
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Address Line | RR 1 BOX 45C
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City | GOLDEN EAGLE
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State | IL
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Zip | 62036-9753
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Country | US
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Telephone | 618-363-0750
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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