Kelly Faulkner, M.S., CCC-SLP

Individual provider Active NPI Speech-Language Pathologist · Ardmore, TN

NPI 1962746461 · NPPES record last updated Nov 21, 2012

Key facts

NPI
1962746461
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
2936 (TN)
Practice address
25385 Main St
Ardmore, TN 38449-3155
Phone
(931) 427-2143
NPI assigned
Nov 21, 2012
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 Science

State licenses

LicenseStateTypeSpecialty
2936TNMDSports Medicine (Neuromusculoskeletal Medicine) Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 2936 TN Yes

Addresses

Primary practice location

25385 Main St
Ardmore, TN 38449-3155

Mailing address

25385 Main St
Ardmore, TN 38449-3155
Phone (931) 427-2143

Other providers in Ardmore, TN

All providers in Ardmore, TN · Speech-Language Pathologist in Tennessee

Sources for this page

Verify at the official NPI Registry.