MEDICARE: MRS. KELYN MARIE NAVARRETE M.S C.F S.L.P

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	3146154	WI

General Provider Information

NPI Number	:	1992945638
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KELYN MARIE NAVARRETE M.S C.F S.L.P

Provider Business Mailing Address
First Line	:	708 EAGLE HTS
Second Line	:	APT. J
City	:	MADISON
State	:	WI
Zip	:	53705-1593
Country	:	US
Telephone Number	:	920-268-5009
Fax Number	:

Provider Business Practice Location Address
First Line	:	303 S JEFFERSON ST
Second Line	:
City	:	VERONA
State	:	WI
Zip	:	53593-1415
Country	:	US
Telephone Number	:	608-845-1306
Fax Number	:	608-845-1307

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

Provider Enumeration Date	:	02/20/2009
Last Update Date	:	02/20/2009

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Directions to “ MRS. KELYN MARIE NAVARRETE M.S C.F S.L.P” Practice Location

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