Doctor Name: | KELLY M BONNETTE |
NPI Number: | 1407973852 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MA CCCSLP |
License Number: | 4044 |
Business Practice Address: | 3 Goldsborough St Suite 300 Easton, MD - 216013101 |
Business Phone Number: | 4107703020 |
Business Fax Number: | |
Mailing Address: | 3 Goldsborough St, Suite 300 EASTON |
State: | MD |
Postal Code: | 216013101 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 03/23/2007 |
NPI Last Update Date: | 03/15/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 4044 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MD |
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 |