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NPI Code Detail

MEDICARE: KELLIE CLITES

MEDICARE: KELLIE CLITES
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 Pathologist2013008763MO
2235Z00000XSpeech-Language PathologistSL014796PA

General Provider Information

NPI Number : 1679816540
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELLIE CLITES
Provider Business Mailing Address
First Line : 685 ANGELA DR
Second Line :
City : GREENSBURG
State : PA
Zip : 15601-2655
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 685 ANGELA DR
Second Line :
City : GREENSBURG
State : PA
Zip : 15601-2655
Country : US
Telephone Number : 724-837-6070
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/29/2013
Last Update Date : 05/05/2020

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Directions to “ KELLIE CLITES ” 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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