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NPI Code Detail

MEDICARE: BREANNA LYNN KELLY M.S. CF-SLP

MEDICARE: BREANNA LYNN KELLY M.S. CF-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
1235Z00000XSpeech-Language Pathologist121423TX

General Provider Information

NPI Number : 1871364372
Entity Type Code : Individual
Provider Name (Legal Business Name) : BREANNA LYNN KELLY M.S. CF-SLP
Provider Business Mailing Address
First Line : 6040 PARKER BLVD APT 4304
Second Line :
City : NORTH RICHLAND HILLS
State : TX
Zip : 76180-0917
Country : US
Telephone Number : 309-826-5065
Fax Number :
Provider Business Practice Location Address
First Line : 8222 N BELT LINE RD STE 175
Second Line :
City : IRVING
State : TX
Zip : 75063-2276
Country : US
Telephone Number : 972-241-9334
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/12/2024
Last Update Date : 01/12/2024

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Directions to “ BREANNA LYNN KELLY M.S. CF-SLP” Practice Location

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