Doctor Name: | KELLIE BUCHANAN |
NPI Number: | 1730321738 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | SA 9621 |
Business Practice Address: | 11814 Sand Dune Dr Panama City Beach, FL - 324074509 |
Business Phone Number: | 2505960896 |
Business Fax Number: | 7706430400 |
Mailing Address: | 11814 Sand Dune Dr, PANAMA CITY BEACH |
State: | FL |
Postal Code: | 324074509 |
Phone Number: | 2505960896 |
Fax Number: | 7706430400 |
NPI Enumeration Date: | 04/06/2009 |
NPI Last Update Date: | 04/06/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SA 9621 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
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 |