Doctor Name: | MS. KELLY FRANCES GARDNER |
NPI Number: | 1295757524 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MS PA-C, SLP |
License Number: | SP2042 |
Business Practice Address: | 200 Somerset St Millinocket, ME - 044621258 |
Business Phone Number: | 2077235161 |
Business Fax Number: | |
Mailing Address: | 87 Forest Ave, ORONO |
State: | ME |
Postal Code: | 044733653 |
Phone Number: | 2073855154 |
Fax Number: | |
NPI Enumeration Date: | 07/24/2006 |
NPI Last Update Date: | 06/10/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SP2042 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | ME |
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 |