Kelly Breen, MA CCC SLP
Individual provider Active NPI Speech-Language Pathologist · Archbold, OH
NPI 1104249952 · NPPES record last updated Jan 30, 2014
Key facts
- NPI
- 1104249952
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- SP.8324 (OH)
- Practice address
- 205 Nolan Pkwy
Archbold, OH 43502-8404 - Phone
- (567) 444-4800
- NPI assigned
- Jan 30, 2014
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SP.8324 | OH | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SP.8324 | OH | Yes |
Addresses
Primary practice location
205 Nolan Pkwy
Archbold, OH 43502-8404
Mailing address
5475 County Road 4 50
Edgerton, OH 43517-9756
Other providers in Archbold, OH
- Jennifer Renee Bergstedt
- Andrea Marie Bohls
- Sara Heatwole Bojorquez
- Mary Margaret Bowling
- Randy Eugene Box
- Johnathan Britsch
- Michael J Britsch
- Randy Britton
- Candace Brosneck
- Danielle Marie Buckland
All providers in Archbold, OH · Speech-Language Pathologist in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 30, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.