Healthcare Provider Details

I. General information

NPI: 1861707697
Provider Name (Legal Business Name): KELSEY CLAIRE PLICHTA M.S. CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2010
Last Update Date: 08/17/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2301 OHIO DR SUITE 130
PLANO TX
75093-3927
US

IV. Provider business mailing address

2301 OHIO DR SUITE 130
PLANO TX
75093-3927
US

V. Phone/Fax

Practice location:
  • Phone: 972-964-1500
  • Fax:
Mailing address:
  • Phone: 972-964-1500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number105121
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: