Organization Name: | KELLY TEASE, MA, CCC-SLP, INC. |
NPI Number: | 1770631921 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KELLY TEASE (OWNER) |
Mailing Address: | 218 Ringwood Dr Winter Springs |
State: | FL US |
Postal Code: | 327084945 |
Phone Number: | 4076958585 |
Fax Number: | 4076999436 |
NPI Enumeration Date: | 01/06/2007 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
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 |