Provider Demographics
NPI:1306681317
Name:KRAHN, KELSEY JANSEN MARY (SLP-CF)
Entity type:Individual
Prefix:
First Name:KELSEY
Middle Name:JANSEN MARY
Last Name:KRAHN
Suffix:
Gender:F
Credentials:SLP-CF
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3535 WILLOW DR APT 16
Mailing Address - Street 2:
Mailing Address - City:PLOVER
Mailing Address - State:WI
Mailing Address - Zip Code:54467-3524
Mailing Address - Country:US
Mailing Address - Phone:608-606-0599
Mailing Address - Fax:
Practice Address - Street 1:1175 BLUE IRIS CT
Practice Address - Street 2:
Practice Address - City:WISCONSIN RAPIDS
Practice Address - State:WI
Practice Address - Zip Code:54494-4241
Practice Address - Country:US
Practice Address - Phone:715-712-1299
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-01
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist