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NPI Code Detail

MEDICARE: KELLEY ANN COLYOTT CCC-SLP

MEDICARE: KELLEY ANN COLYOTT CCC-SLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language PathologistSLP007118GA

General Provider Information

NPI Number : 1154669216
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELLEY ANN COLYOTT CCC-SLP
Provider Business Mailing Address
First Line : 315 UPPER RIVERDALE RD SW
Second Line :
City : RIVERDALE
State : GA
Zip : 30274-2500
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 315 UPPER RIVERDALE RD SW
Second Line :
City : RIVERDALE
State : GA
Zip : 30274-2500
Country : US
Telephone Number : 770-991-2636
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/24/2013
Last Update Date : 01/24/2013

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Directions to “ KELLEY ANN COLYOTT CCC-SLP” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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