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General NPI Number Information
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NPI Number | 1487907788
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Entity Type | Individual
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Provider Name | KELCI LAUREN SANTOEMMA MS, CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 10/24/2012
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Last Update Date | 01/26/2023
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Provider Practice Location Address
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Address Line | 100 KIMBALL AVE APT H96
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City | SALEM
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State | VA
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Zip | 24153-6709
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Country | US
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Telephone | 570-574-8104
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Fax |
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Provider Business Mailing Address
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Address Line | 2455 HEATHER RD
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City | YORK
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State | PA
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Zip | 17408-4384
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Country | US
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Telephone | 570-574-8104
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Fax |
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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 | 2202006725
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SL012931
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License Number State | PA
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