Provider Demographics
NPI:1538617287
Name:KELLY TWEHUES, LLC
Entity type:Organization
Organization Name:KELLY TWEHUES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/SLP
Authorized Official - Prefix:
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:CRAWFORD
Authorized Official - Last Name:TWEHUES
Authorized Official - Suffix:
Authorized Official - Credentials:MA CCC-SLP
Authorized Official - Phone:859-441-0139
Mailing Address - Street 1:18 N FORT THOMAS AVE STE 302
Mailing Address - Street 2:
Mailing Address - City:FORT THOMAS
Mailing Address - State:KY
Mailing Address - Zip Code:41075-1595
Mailing Address - Country:US
Mailing Address - Phone:859-441-0139
Mailing Address - Fax:859-441-0125
Practice Address - Street 1:18 N FORT THOMAS AVE STE 302
Practice Address - Street 2:
Practice Address - City:FORT THOMAS
Practice Address - State:KY
Practice Address - Zip Code:41075-1595
Practice Address - Country:US
Practice Address - Phone:859-441-0139
Practice Address - Fax:859-441-0125
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-12
Last Update Date:2022-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
235Z00000X, 261QP2000X
KY138430252Y00000X, 261QH0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No252Y00000XAgenciesEarly Intervention Provider AgencyGroup - Multi-Specialty
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy