Provider Demographics
NPI:1992945638
Name:NAVARRETE, KELYN MARIE (MS CF SLP)
Entity type:Individual
Prefix:MRS
First Name:KELYN
Middle Name:MARIE
Last Name:NAVARRETE
Suffix:
Gender:F
Credentials:MS CF SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:708 EAGLE HTS
Mailing Address - Street 2:APT. J
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53705-1593
Mailing Address - Country:US
Mailing Address - Phone:920-268-5009
Mailing Address - Fax:
Practice Address - Street 1:303 S JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:VERONA
Practice Address - State:WI
Practice Address - Zip Code:53593-1415
Practice Address - Country:US
Practice Address - Phone:608-845-1306
Practice Address - Fax:608-845-1307
Is Sole Proprietor?:No
Enumeration Date:2009-02-20
Last Update Date:2009-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3146154235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist