Provider Demographics
NPI:1427702273
Name:SCHALL, KELSEY (CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:KELSEY
Middle Name:
Last Name:SCHALL
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:KELSEY
Other - Middle Name:
Other - Last Name:YAISER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:308 VAN SANT AVE
Mailing Address - Street 2:
Mailing Address - City:LINWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08221-1735
Mailing Address - Country:US
Mailing Address - Phone:609-661-0995
Mailing Address - Fax:
Practice Address - Street 1:523 HADDON AVE
Practice Address - Street 2:
Practice Address - City:COLLINGSWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08108-1401
Practice Address - Country:US
Practice Address - Phone:856-983-3390
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-10
Last Update Date:2022-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS01122600235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist