Individual
KELSEY SAMUEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.ED., CCC-SLP
Contact information
Practice address
9500 NORFOLK ST, GLEN ALLEN, VA 23060-2381
(804) 261-5095
Mailing address
9500 NORFOLK ST, GLEN ALLEN, VA 23060-2381
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2202009242
VA
Other
Enumeration date
01/05/2020
Last updated
02/17/2021
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