MEDICARE: KELSIE CLIFTON SLPA

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
1	2355S0801X	Speech-Language Assistant	SI6056	FL

General Provider Information

NPI Number	:	1619702859
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KELSIE CLIFTON SLPA

Provider Business Mailing Address
First Line	:	4181 GLADE RD
Second Line	:
City	:	SPRING HILL
State	:	FL
Zip	:	34606-6856
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5162 MARINER BLVD
Second Line	:
City	:	SPRING HILL
State	:	FL
Zip	:	34609-1802
Country	:	US
Telephone Number	:	352-600-8300
Fax Number	:	352-251-3161

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/06/2024
Last Update Date	:	09/06/2024

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Directions to “ KELSIE CLIFTON SLPA” Practice Location

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