Provider Demographics
NPI:1194419283
Name:POWELL, KELSEY ANNE (CF-SLP)
Entity type:Individual
Prefix:
First Name:KELSEY
Middle Name:ANNE
Last Name:POWELL
Suffix:
Gender:F
Credentials:CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1421 SOUTHHAMPTON DR
Mailing Address - Street 2:
Mailing Address - City:BOURBONNAIS
Mailing Address - State:IL
Mailing Address - Zip Code:60914-1628
Mailing Address - Country:US
Mailing Address - Phone:815-370-3822
Mailing Address - Fax:
Practice Address - Street 1:4540 W 10TH AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80204-2913
Practice Address - Country:US
Practice Address - Phone:720-424-8300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-05
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist