Individual
MS. PAULA R KELSEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
2207 E FOXBOROUGH DR, REPUBLIC, MO 65738-1762
(417) 732-7098
Mailing address
2207 E. FOXBOROUGH DRIVE, REPUBLIC, MO 65738
(417) 732-7098
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2000174936
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12003378
ASHA CERTIFICATION
DC
01
—
2000174936
STATE LICENSE SPEECH PATHOLOGY, MISSOURI
MO
Enumeration date
06/30/2010
Last updated
07/26/2010
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