Doctor Name: | KELLY KIRK |
NPI Number: | 1265825509 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CCC-SLP |
License Number: | SL012019 |
Business Practice Address: | 3740 Milligantown Rd Lower Burrell, PA - 150687121 |
Business Phone Number: | 7245940676 |
Business Fax Number: | |
Mailing Address: | 2013 Redcoach Rd, ALLISON PARK |
State: | PA |
Postal Code: | 151013230 |
Phone Number: | 4123041871 |
Fax Number: | |
NPI Enumeration Date: | 03/11/2015 |
NPI Last Update Date: | 03/11/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SL012019 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
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 |