Doctor Name: | MS. ANDREA KELLEY |
NPI Number: | 1205978459 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S,CCC-SLP |
License Number: | SA8421 |
Business Practice Address: | 10917 N Dale Mabry Hwy Tampa, FL - 336184112 |
Business Phone Number: | 8139626766 |
Business Fax Number: | |
Mailing Address: | 4301 W Granada St, TAMPA |
State: | FL |
Postal Code: | 336296618 |
Phone Number: | 8137871831 |
Fax Number: | |
NPI Enumeration Date: | 02/13/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SA8421 |
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 |