Provider Demographics
NPI:1033786496
Name:BOYER, KELLY LINDERS (MS CCC-A/SLP)
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:LINDERS
Last Name:BOYER
Suffix:
Gender:F
Credentials:MS CCC-A/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1528 ESTATES WAY
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75006-1527
Mailing Address - Country:US
Mailing Address - Phone:469-274-1277
Mailing Address - Fax:
Practice Address - Street 1:1528 ESTATES WAY
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75006-1527
Practice Address - Country:US
Practice Address - Phone:469-274-1277
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-04
Last Update Date:2021-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX101992235Z00000X
TX50842231HA2400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No231HA2400XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology Practitioner