Kelli Banta
NPI #1003591769 in Hattiesburg, Mississippi
Provider Information
- NPI Number
- 1003591769
- Entity Type
- Individual
- Name
- Kelli Banta
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Speech-Language Pathologist
- Enumeration Date
- Jun 20, 2023
- Last Updated
- Jun 20, 2023
Practice Location
- Address
- 4805 W 4TH ST
- City
- Hattiesburg
- State
- Mississippi
- ZIP Code
- 39402-1019
- Phone
- (601) 270-6968
Specialties & Taxonomy Codes
| Specialty |
|---|
| Speech-Language Pathologist |
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