Doctor Name: | KELLY ANSON |
NPI Number: | 1720108657 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S. CCC-SLP |
License Number: | 1172 |
Business Practice Address: | 120 S State Highway 45b Ewing, NE - 687355356 |
Business Phone Number: | 4023947068 |
Business Fax Number: | |
Mailing Address: | 120 S State Highway 45b, EWING |
State: | NE |
Postal Code: | 687355356 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 04/02/2007 |
NPI Last Update Date: | 11/29/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 1172 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NE |
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 |