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NPI Code Detail

MEDICARE: KILSY MIGUELINA BERNARD MS, CCC-SLP

MEDICARE: KILSY MIGUELINA BERNARD MS, 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 Pathologist
2390200000XStudent in an Organized Health Care Education/Training ProgramNY
3235Z00000XSpeech-Language PathologistSLP011404GA

General Provider Information

NPI Number : 1508310590
Entity Type Code : Individual
Provider Name (Legal Business Name) : KILSY MIGUELINA BERNARD MS, CCC-SLP
Provider Business Mailing Address
First Line : 3500 DEPAUW BLVD STE 3070
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46268-6135
Country : US
Telephone Number : 855-324-0885
Fax Number : 317-520-8200
Provider Business Practice Location Address
First Line : 2651 DALLAS HWY SW
Second Line :
City : MARIETTA
State : GA
Zip : 30064-2541
Country : US
Telephone Number : 678-486-1904
Fax Number : 317-520-8200
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/08/2016
Last Update Date : 03/05/2021

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Directions to “ KILSY MIGUELINA BERNARD MS, CCC-SLP” Practice Location

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