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General NPI Number Information
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NPI Number | 1588908479
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Entity Type | Individual
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Provider Name | KALEY VALLELONGA M.S., CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 11/16/2012
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Last Update Date | 09/10/2013
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Provider Practice Location Address
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Address Line | 2635 SCOTTSVILLE RD
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City | BOWLING GREEN
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State | KY
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Zip | 42104-4410
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Country | US
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Telephone | 270-842-1641
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Fax |
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Provider Business Mailing Address
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Address Line | 4576 PETROS RD
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City | WOODBURN
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State | KY
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Zip | 42170-9753
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Country | US
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Telephone | 270-799-2132
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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 | 4024
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License Number State | KY
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