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General NPI Number Information
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NPI Number | 1194854166
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Entity Type | Individual
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Provider Name | MRS. KELLY ANNE HART
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Gender | Female
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Dates
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Enumeration Date | 03/05/2007
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Last Update Date | 06/27/2014
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Provider Practice Location Address
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Address Line | 32 SPUR CIR
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City | SCOTTSDALE
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State | AZ
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Zip | 85251-5461
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Country | US
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Telephone | 480-945-0185
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Fax | 480-656-3948
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Provider Business Mailing Address
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Address Line | 32 SPUR CIR
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City | SCOTTSDALE
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State | AZ
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Zip | 85251-5461
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Country | US
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Telephone | 480-945-0185
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Fax | 480-656-3948
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SLP5101
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 2355S0801X
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Taxonomy Name | Speech-Language Assistant
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License Number | SLPA6306
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License Number State | AZ
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