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General NPI Number Information
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NPI Number | 1235518630
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Entity Type | Individual
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Provider Name | LAURA KELLY M.A., CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 05/19/2015
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Last Update Date | 08/15/2017
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Provider Practice Location Address
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Address Line | 3329 SAINT GEORGES WAY
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City | LOVELAND
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State | OH
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Zip | 45140-1551
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Country | US
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Telephone | 513-924-2545
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Fax | 513-396-5593
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Provider Business Mailing Address
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Address Line | 3329 SAINT GEORGES WAY
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City | LOVELAND
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State | OH
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Zip | 45140-1551
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Country | US
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Telephone | 513-924-2545
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Fax | 513-396-5593
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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 | SP.11704
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License Number State | OH
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