Provider Demographics
NPI:1467723189
Name:FARRIS, KALI RENEE (MS CCC-SLP)
Entity type:Individual
Prefix:
First Name:KALI
Middle Name:RENEE
Last Name:FARRIS
Suffix:
Gender:
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:KALI
Other - Middle Name:RENEE
Other - Last Name:WHITESIDE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS CCC-SLP
Mailing Address - Street 1:PO BOX 14086
Mailing Address - Street 2:
Mailing Address - City:POLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44514-7086
Mailing Address - Country:US
Mailing Address - Phone:330-770-2708
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 14086
Practice Address - Street 2:
Practice Address - City:POLAND
Practice Address - State:OH
Practice Address - Zip Code:44514-7086
Practice Address - Country:US
Practice Address - Phone:330-770-2708
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-26
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL010500235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist