Doctor Name: | MS. KRISTINA L KELLY |
NPI Number: | 1902002157 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S., CCC-SLP |
License Number: | SA11782 |
Business Practice Address: | 12773 Forest Hill Blvd Suite 217 Wellington, FL - 334144767 |
Business Phone Number: | 2077980746 |
Business Fax Number: | |
Mailing Address: | 12773 Forest Hill Blvd, Suite 217 WELLINGTON |
State: | FL |
Postal Code: | 334144767 |
Phone Number: | 2077980746 |
Fax Number: | |
NPI Enumeration Date: | 06/25/2007 |
NPI Last Update Date: | 01/21/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SA11782 |
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 |