Individual
KELLY ANN DECAIRE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A CCC-SLP
Contact information
Practice address
85 BEAUMONT DR, NORTHBRIDGE, MA 01534-1093
(508) 321-7975
Mailing address
2701 CHESTNUT STATION CT, LOUISVILLE, KY 40299-6395
(800) 335-1060
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
5992
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
235Z00000X
—
MA
Enumeration date
12/04/2018
Last updated
12/04/2018
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