Individual
MRS. KELLY SUZANNE THEIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S. SLP
Contact information
Practice address
24 IDLEWILD AVE, CORNWALL ON HUDSON, NY 12520-1134
(845) 534-8009
Mailing address
30 BETHLEHEM RD, NEW WINDSOR, NY 12553-8903
(845) 863-7861
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
018477
NY
251300000X
Local Education Agency (LEA)
Primary
018477
NY
Other
Enumeration date
01/12/2012
Last updated
01/12/2012
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