Individual
KELLY FAGEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CF-SLP
Contact information
Practice address
4325 RED BANK RD, CINCINNATI, OH 45227-2174
(513) 271-2419
Mailing address
PO BOX 411169, BOSTON, MA 02241-1169
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
COND.20211874-SP
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0406425
—
OH
Enumeration date
06/03/2022
Last updated
09/15/2022
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