Provider Demographics
NPI:1962691121
Name:SIMINSKI, KELLY MICHELLE (MA CCC/SLP)
Entity type:Individual
Prefix:MRS
First Name:KELLY
Middle Name:MICHELLE
Last Name:SIMINSKI
Suffix:
Gender:F
Credentials:MA CCC/SLP
Other - Prefix:
Other - First Name:KELLY
Other - Middle Name:MICHEELLE
Other - Last Name:DRESSLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:45 STATE ST
Mailing Address - Street 2:
Mailing Address - City:BROCKPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14420-1921
Mailing Address - Country:US
Mailing Address - Phone:716-288-4770
Mailing Address - Fax:
Practice Address - Street 1:150 STAHL RD
Practice Address - Street 2:
Practice Address - City:GETZVILLE
Practice Address - State:NY
Practice Address - Zip Code:14068-1231
Practice Address - Country:US
Practice Address - Phone:716-629-3400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-23
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010514-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist