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General NPI Number Information
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NPI Number | 1720234230
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Entity Type | Individual
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Provider Name | MRS. KELLEY WOOD
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Gender | Female
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Dates
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Enumeration Date | 08/15/2008
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Last Update Date | 10/03/2022
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Provider Practice Location Address
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Address Line | 4400 W 115TH ST
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City | LEAWOOD
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State | KS
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Zip | 66211-2684
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Country | US
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Telephone | 913-348-6362
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Fax |
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Provider Business Mailing Address
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Address Line | 15504 S ARAPAHO ST
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City | OLATHE
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State | KS
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Zip | 66062-5054
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Country | US
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Telephone |
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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 | 22003237A
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License Number State | IN
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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 | 10004714
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License Number State | KS
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