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General NPI Number Information
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NPI Number | 1992216774
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Entity Type | Individual
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Provider Name | KELSEY LYNNE CULBERTSON AUD
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Gender | Female
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Dates
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Enumeration Date | 10/19/2017
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 282 WASHINTON STREET SUITE 2F
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City | HARTFORD
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State | CT
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Zip | 06106
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Country | US
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Telephone | 860-545-9642
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Fax |
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Provider Business Mailing Address
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Address Line | 282 WASHINGTON ST STE 2F
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City | HARTFORD
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State | CT
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Zip | 06106-3322
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Country | US
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Telephone | 848-545-9642
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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 | 00580
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License Number State | CT
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