Kelly Fish

Individual provider Active NPI Speech-Language Pathologist · Veazie, ME

NPI 1447567219 · NPPES record last updated Sep 1, 2010

Key facts

NPI
1447567219
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
SP1085 (ME)
Practice address
1040 School St
Veazie, ME 04401-6950
Phone
(207) 947-6573
NPI assigned
Sep 1, 2010
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

State licenses

LicenseStateTypeSpecialty
SP1085MEMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SP1085 ME Yes

Addresses

Primary practice location

1040 School St
Veazie, ME 04401-6950

Mailing address

1040 School St
Veazie, ME 04401-6950
Phone (207) 947-6573

Other providers in Veazie, ME

All providers in Veazie, ME · Speech-Language Pathologist in Maine

Sources for this page

Verify at the official NPI Registry.