Provider Demographics
NPI:1285959494
Name:HILBORN, KELLY LEE (MA CCC-SLP)
Entity type:Individual
Prefix:
First Name:KELLY
Middle Name:LEE
Last Name:HILBORN
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10480 MISTY RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:CONCORD TOWNSHIP
Mailing Address - State:OH
Mailing Address - Zip Code:44077-9002
Mailing Address - Country:US
Mailing Address - Phone:440-554-9778
Mailing Address - Fax:
Practice Address - Street 1:27100 CEDAR RD
Practice Address - Street 2:
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-1109
Practice Address - Country:US
Practice Address - Phone:216-831-6500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-30
Last Update Date:2023-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH9457235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist