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NPI Code Detail

MEDICARE: MRS. KELLI-LYNN A REFF M.S.ED. CCC-SLP

MEDICARE: MRS. KELLI-LYNN A REFF M.S.ED. 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 Pathologist2202005635VA

General Provider Information

NPI Number : 1356586846
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KELLI-LYNN A REFF M.S.ED. CCC-SLP
Provider Business Mailing Address
First Line : 3924 PETERSON ST
Second Line :
City : NORFOLK
State : VA
Zip : 23513-4247
Country : US
Telephone Number : 757-474-1249
Fax Number :
Provider Business Practice Location Address
First Line : 4560 PRINCESS ANNE RD
Second Line :
City : VIRGINIA BEACH
State : VA
Zip : 23462-7905
Country : US
Telephone Number : 757-474-1249
Fax Number : 757-474-0193
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/11/2008
Last Update Date : 12/11/2008

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