Doctor Name: | GINA M KELLER |
NPI Number: | 1922124882 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MSCCCSLP |
License Number: | SL008643 |
Business Practice Address: | 44 Donaldson Rd Tremont, PA - 179811424 |
Business Phone Number: | 5706953493 |
Business Fax Number: | |
Mailing Address: | 162 Twin Creeks Dr, Po Box 7 JONESTOWN |
State: | PA |
Postal Code: | 170388319 |
Phone Number: | 5705901037 |
Fax Number: | |
NPI Enumeration Date: | 03/22/2007 |
NPI Last Update Date: | 11/05/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SL008643 |
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 |