Doctor Name: | MS. CATHERINE MARIE KELLY |
NPI Number: | 1043342538 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CCC-SLP |
License Number: | 1230 |
Business Practice Address: | 4216 Balloon Park Rd Ne Albuquerque, NM - 871095801 |
Business Phone Number: | 5053445470 |
Business Fax Number: | 5053449343 |
Mailing Address: | 4306 Sunningdale Ave Ne, ALBUQUERQUE |
State: | NM |
Postal Code: | 871104946 |
Phone Number: | 5053445470 |
Fax Number: | 5053449343 |
NPI Enumeration Date: | 03/10/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 1230 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NM |
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 |