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General NPI Number Information
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NPI Number | 1962559484
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Entity Type | Individual
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Provider Name | YOLANDA DIANA KELLEY AU.D
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Gender | Female
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Dates
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Enumeration Date | 01/05/2007
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Last Update Date | 02/26/2009
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Provider Practice Location Address
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Address Line | 1601 SW ARCHER RD
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City | GAINESVILLE
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State | FL
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Zip | 32608-1135
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Country | US
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Telephone | 352-376-1611
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Fax |
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Provider Business Mailing Address
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Address Line | 1227 37TH AVE E
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City | TUSCALOOSA
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State | AL
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Zip | 35404-4323
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Country | US
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Telephone | 205-310-6620
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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 | 231H00000X
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Taxonomy Name | Audiologist
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License Number | 0775A
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License Number State | AL
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