Kelly Brousard, SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

01534 Issued in IA

Practice address

402 10TH St SE
Suite 700
Cedar Rapids, IA 52403-2435

Phone

(319) 365-9439

Fax

(319) 365-9368

NPI assigned

Jun 19, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Kelly Doherty Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962447193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5325 E AVE NW",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524053245",
            "telephone_number": "319-390-3013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 10TH ST SE",
            "address_2": "SUITE 700",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524032435",
            "telephone_number": "319-365-9439",
            "fax_number": "319-365-9368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROUSARD",
        "first_name": "KELLY",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IA",
            "license": "01534",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "DOHERTY",
            "credential": "SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Rachel Brookens
• Malakai Brooks
• Michael Steven Brooks, MD
• Ruby Brorby, LMHC-T
• Brian Brotzman, MA, TLMHC
• Breann Nichole Brown, LMSW
• Erica S Brown, ARNP
• Erin Elizabeth Brown, A.R.N.P.
• Holly Conway Brown, M.D.
• Jada Brown

• Speech-Language Pathologist in Cedar Rapids, IA
• Providers in Cedar Rapids, IA by specialty
• Speech-Language Pathologist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.