Individual
EZEKIEL HANS KELSEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
SLP
Contact information
Practice address
392 FALLS AVE, TWIN FALLS, ID 83301-3373
(208) 749-3475
(208) 450-2408
Mailing address
3231 SPRING CREEK DR, TWIN FALLS, ID 83301
(208) 320-5686
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP-1643
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1861686032
—
ID
Enumeration date
08/30/2007
Last updated
03/15/2023
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