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NPI Code Detail

MEDICARE: KELLY FAGEL CF-SLP

MEDICARE: KELLY FAGEL 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 PathologistCOND.20211874-SPOH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1932848181
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELLY FAGEL CF-SLP
Provider Business Mailing Address
First Line : PO BOX 411169
Second Line :
City : BOSTON
State : MA
Zip : 02241-1169
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4325 RED BANK RD
Second Line :
City : CINCINNATI
State : OH
Zip : 45227-2174
Country : US
Telephone Number : 513-271-2419
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/03/2022
Last Update Date : 09/15/2022

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Directions to “ KELLY FAGEL CF-SLP” Practice Location

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