Doctor Name: | MRS. KELLY LYNN WAUTHIER |
NPI Number: | 1538154091 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S., CCC-SLP |
License Number: | SL003861L |
Business Practice Address: | 424 Frederick Ave Sewickley, PA - 151431523 |
Business Phone Number: | 4127414087 |
Business Fax Number: | 4127416808 |
Mailing Address: | 424 Frederick Ave, SEWICKLEY |
State: | PA |
Postal Code: | 151431523 |
Phone Number: | 4127414087 |
Fax Number: | 4127416808 |
NPI Enumeration Date: | 09/12/2005 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SL003861L |
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 |