Doctor Name: | KELLY M KANELLIS |
NPI Number: | 1174811053 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S., CCC-SLP |
License Number: | 9587 |
Business Practice Address: | 3100 Nc 55 Hwy #101 Cary, NC - 275198426 |
Business Phone Number: | 9193635000 |
Business Fax Number: | |
Mailing Address: | 3100 Nc 55 Hwy, #101 CARY |
State: | NC |
Postal Code: | 275198426 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 07/13/2011 |
NPI Last Update Date: | 07/20/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 9587 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
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 |