Provider Demographics
NPI:1346619418
Name:MELUCCI, KELSEY (AUD)
Entity type:Individual
Prefix:
First Name:KELSEY
Middle Name:
Last Name:MELUCCI
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 1:3595 POST RD
Mailing Address - Street 2:APT 12-201
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886-7078
Mailing Address - Country:US
Mailing Address - Phone:615-308-4875
Mailing Address - Fax:
Practice Address - Street 1:1351 S COUNTY TRL
Practice Address - Street 2:BUILDING 3, SUITE 304
Practice Address - City:EAST GREENWICH
Practice Address - State:RI
Practice Address - Zip Code:02818-5105
Practice Address - Country:US
Practice Address - Phone:401-626-3708
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-18
Last Update Date:2015-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIAUD00222231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist