Individual
KELSEY AURAND DE RAZO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, CCC-SLP
Contact information
Practice address
203 PARK PLZ, KIRKSVILLE, MO 63501-1969
(660) 785-0500
Mailing address
PO BOX 589, KIRKSVILLE, MO 63501-0589
(660) 785-0500
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2015037212
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14053535
AMERICAN SPEECH-LANGUAGE-HEARING ASSOCIATION
—
01
—
2015037212
DIVISION OF PROFESSIONAL REGISTRATION
MO
Enumeration date
05/24/2022
Last updated
05/24/2022
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