Kellie Bouren

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

7101000845 Issued in MI

Practice address

30503 Greenfield Rd
Southfield, MI 48076-1594

Phone

(248) 691-4732

NPI assigned

Nov 6, 2018

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1541462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735516800000",
    "number": "1902374150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4949 COOLIDGE HWY",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480731026",
            "telephone_number": "248-655-5975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30503 GREENFIELD RD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480761594",
            "telephone_number": "248-691-4732"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6900 Orchard Lake Rd",
            "address_purpose": "LOCATION",
            "city": "West Bloomfield",
            "state": "MI",
            "postal_code": "483223405",
            "country_code": "US",
            "telephone_number": "248-855-4480",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "17150 Waterloo St",
            "address_purpose": "LOCATION",
            "city": "Grosse Pointe",
            "state": "MI",
            "postal_code": "482301201",
            "country_code": "US",
            "telephone_number": "313-473-4730",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "15959 Hall Rd",
            "address_purpose": "LOCATION",
            "city": "Macomb",
            "state": "MI",
            "postal_code": "480445363",
            "country_code": "US",
            "telephone_number": "586-416-6290",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4949 Coolidge Hwy",
            "address_purpose": "LOCATION",
            "city": "Royal Oak",
            "state": "MI",
            "postal_code": "480731026",
            "country_code": "US",
            "telephone_number": "248-655-5975",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOUREN",
        "first_name": "KELLIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-11-06",
        "last_updated": "2024-12-30",
        "certification_date": "2024-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MI",
            "license": "7101000845",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristin Bouchard, RN
• Arthur I Bouier Jr., DO
• Tamer Nady Boules, M.D.
• Austyn Lynnell Boulware
• Jeffrey Dean Bounsall, CRNA
• Kristen Bourgon, MSN, AGPCNP-BC
• Anthony Edward Boutt, MD
• Angel Bowen
• Anthony Darrell Bowens, MA, LLPC
• Bower Enterprises II

• Speech-Language Pathologist in Southfield, MI
• Providers in Southfield, MI by specialty
• Speech-Language Pathologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.