Provider Demographics
NPI:1033470943
Name:KAMP, KELLY (AUD)
Entity Type:Individual
Prefix:DR
First Name:KELLY
Middle Name:
Last Name:KAMP
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:97 HAMBURG ST
Mailing Address - Street 2:
Mailing Address - City:EAST AURORA
Mailing Address - State:NY
Mailing Address - Zip Code:14052-2139
Mailing Address - Country:US
Mailing Address - Phone:716-652-6464
Mailing Address - Fax:716-652-6499
Practice Address - Street 1:97 HAMBURG ST
Practice Address - Street 2:
Practice Address - City:EAST AURORA
Practice Address - State:NY
Practice Address - Zip Code:14052-2139
Practice Address - Country:US
Practice Address - Phone:716-652-6464
Practice Address - Fax:716-652-6499
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-06
Last Update Date:2022-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002406231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist