Provider Demographics
NPI:1154724557
Name:BORER, KELSEY LAUREN (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:KELSEY
Middle Name:LAUREN
Last Name:BORER
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8015 RAYTOWN RD
Mailing Address - Street 2:
Mailing Address - City:RAYTOWN
Mailing Address - State:MO
Mailing Address - Zip Code:64138-2106
Mailing Address - Country:US
Mailing Address - Phone:816-268-7280
Mailing Address - Fax:
Practice Address - Street 1:8015 RAYTOWN RD
Practice Address - Street 2:
Practice Address - City:RAYTOWN
Practice Address - State:MO
Practice Address - Zip Code:64138-2106
Practice Address - Country:US
Practice Address - Phone:816-268-7280
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-30
Last Update Date:2014-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2014027543235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist