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NPI Code Detail

MEDICARE: KELLY A MCSTRAVOCK

MEDICARE: KELLY A MCSTRAVOCK
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist7176SC
2235Z00000XSpeech-Language Pathologist9733NC

General Provider Information

NPI Number : 1063256170
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELLY A MCSTRAVOCK
Provider Business Mailing Address
First Line : 4494 HADDINGTON DR
Second Line :
City : INDIAN LAND
State : SC
Zip : 29707-2505
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4421 STUART ANDREW BLVD
Second Line :
City : CHARLOTTE
State : NC
Zip : 28217-1589
Country : US
Telephone Number : 940-343-6960
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/24/2024
Last Update Date : 06/10/2026

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Directions to “ KELLY A MCSTRAVOCK ” Practice Location

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