Individual
MS. KELLY D BECKNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S. CCC-SLP
Contact information
Practice address
1215 CORPORATE CIR SW STE 201, ROANOKE, VA 24018-1400
(540) 312-7066
(540) 390-0195
Mailing address
1215 CORPORATE CIR SW STE 201, ROANOKE, VA 24018-1400
(540) 312-7066
(540) 390-0195
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2202004349
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004978331
—
VA
01
—
195182
ANTHEM
VA
01
—
240052
MAMSI
VA
01
—
7088632
AETNA
VA
Enumeration date
10/27/2006
Last updated
04/15/2024
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