| Organization Name: | KELLY M. HARRIS, MS, CCC-SLP, LLC |
| NPI Number: | 1144547407 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KELLY M HARRIS (SPEECH-LANGUAGE PATHOLOGIST/OWNER) |
| Mailing Address: | 404 Sw Talquin Ln Port Saint Lucie |
| State: | FL US |
| Postal Code: | 349862062 |
| Phone Number: | 7724186272 |
| Fax Number: | 7727859282 |
| NPI Enumeration Date: | 04/27/2010 |
| NPI Last Update Date: | 04/27/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | SA6451 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| 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 |