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Organization
SPEECH, LANGUAGE & SWALLOWING CONSULTANTS P.C.
Active
Organization
SPEECH, LANGUAGE & SWALLOWING CONSULTANTS P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LISA ANN KELLY M.S. CCC-SLP (PRESIDENT)
(631) 765-3620
Entity
Organization
Contact information
Practice address
57190 MAIN RD, SOUTHOLD, NY 11971-4750
(631) 765-3620
Mailing address
57190 MAIN RD, P.O. BOX 1562, SOUTHOLD, NY 11971-4750
(631) 765-3620
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
016296-1
NY
235Z00000X
Speech-Language Pathologist
016352-1
NY
Other
Enumeration date
05/12/2006
Last updated
08/22/2020
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