Provider Demographics
NPI:1972209971
Name:MICHAUD, KELSEY (MA, CCC-SLP)
Entity type:Individual
Prefix:
First Name:KELSEY
Middle Name:
Last Name:MICHAUD
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 RIVERWOODS DR
Mailing Address - Street 2:
Mailing Address - City:EXETER
Mailing Address - State:NH
Mailing Address - Zip Code:03833-4374
Mailing Address - Country:US
Mailing Address - Phone:603-772-4700
Mailing Address - Fax:
Practice Address - Street 1:7 RIVERWOODS DR
Practice Address - Street 2:
Practice Address - City:EXETER
Practice Address - State:NH
Practice Address - Zip Code:03833-4374
Practice Address - Country:US
Practice Address - Phone:603-772-4700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-01
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH2314235Z00000X
MA77766-SP-SL235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist