Provider Demographics
NPI:1285955682
Name:CARDER, KELLYE CHRISTINE (AUD)
Entity type:Individual
Prefix:DR
First Name:KELLYE
Middle Name:CHRISTINE
Last Name:CARDER
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 COMMERCE BLVD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:WEST GROVE
Mailing Address - State:PA
Mailing Address - Zip Code:19390-9198
Mailing Address - Country:US
Mailing Address - Phone:610-395-0977
Mailing Address - Fax:
Practice Address - Street 1:460 CREAMERY WAY
Practice Address - Street 2:SUITE 103
Practice Address - City:EXTON
Practice Address - State:PA
Practice Address - Zip Code:19341-2533
Practice Address - Country:US
Practice Address - Phone:610-384-8300
Practice Address - Fax:610-384-8885
Is Sole Proprietor?:No
Enumeration Date:2010-06-20
Last Update Date:2010-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAT006168231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist