Provider Demographics
NPI:1316769243
Name:PERRY, KERI (MS-CCC-SLP)
Entity type:Individual
Prefix:
First Name:KERI
Middle Name:
Last Name:PERRY
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 1:548 COMPASS CIR
Mailing Address - Street 2:
Mailing Address - City:NORTH SALT LAKE
Mailing Address - State:UT
Mailing Address - Zip Code:84054-1953
Mailing Address - Country:US
Mailing Address - Phone:925-270-5956
Mailing Address - Fax:
Practice Address - Street 1:548 COMPASS CIR
Practice Address - Street 2:
Practice Address - City:NORTH SALT LAKE
Practice Address - State:UT
Practice Address - Zip Code:84054-1953
Practice Address - Country:US
Practice Address - Phone:925-270-5956
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-30
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT9291496-4102235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist