Individual
KELSEA F CIAVAGLIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
A-SLP
Contact information
Practice address
1617 PARK PLACE AVE, SUITE 110, FORT WORTH, TX 76110-1300
(817) 921-5020
(817) 921-5022
Mailing address
1617 PARK PLACE AVE, SUITE 110, FORT WORTH, TX 76110-1300
(817) 921-5020
(817) 921-5022
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
35937
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
149984001
—
TX
05
—
207164901
—
TX
Enumeration date
01/24/2011
Last updated
01/24/2011
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