Provider Demographics
NPI:1023545811
Name:MCGUFFEY, KELSEY SMITH (MA)
Entity Type:Individual
Prefix:MRS
First Name:KELSEY
Middle Name:SMITH
Last Name:MCGUFFEY
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:336 DALLAS DR
Mailing Address - Street 2:
Mailing Address - City:HUSTONVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40437-8304
Mailing Address - Country:US
Mailing Address - Phone:606-669-2247
Mailing Address - Fax:
Practice Address - Street 1:336 DALLAS DR
Practice Address - Street 2:
Practice Address - City:HUSTONVILLE
Practice Address - State:KY
Practice Address - Zip Code:40437-8304
Practice Address - Country:US
Practice Address - Phone:606-669-2247
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-11
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY173107235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist