Provider Demographics
NPI:1043615917
Name:BROWN, KELSEY (MA CCC-SLP)
Entity Type:Individual
Prefix:
First Name:KELSEY
Middle Name:
Last Name:BROWN
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 1:3207 LAKESIDE TRL
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77077-1685
Mailing Address - Country:US
Mailing Address - Phone:713-835-5325
Mailing Address - Fax:832-900-1112
Practice Address - Street 1:3207 LAKESIDE TRL
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77077-1685
Practice Address - Country:US
Practice Address - Phone:713-835-5325
Practice Address - Fax:832-900-1112
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-04
Last Update Date:2019-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX108723235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist