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Individual

KELLI CHRISTINE BAVARO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.S., CCC-SLP

Contact information

Practice address
121 MOUNT VERNON ST, BOSTON, MA 02108-1104
(617) 723-8255
Mailing address
455 WINDROSE WAY, CHULA VISTA, CA 91910-7400
(631) 790-6290

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
20172
CA
235Z00000X
Speech-Language Pathologist
8242740
NY

Other

Enumeration date
08/30/2013
Last updated
08/04/2023
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