MEDICARE: KELLIE KATHLEEN VOSS M.A. CCC-SLP

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
1	235Z00000X	Speech-Language Pathologist	SLP10714	AZ

General Provider Information

NPI Number	:	1477062495
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KELLIE KATHLEEN VOSS M.A. CCC-SLP

Provider Business Mailing Address
First Line	:	4530 E MCDOWELL RD APT 267
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85008-4525
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4505 E PALM LN
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85008-4123
Country	:	US
Telephone Number	:	602-629-6752
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/21/2017
Last Update Date	:	09/21/2017

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Directions to “ KELLIE KATHLEEN VOSS M.A. CCC-SLP” Practice Location

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