Provider Demographics
NPI:1073852703
Name:AMRITT, KERRI KELLESIA (MS SLP)
Entity Type:Individual
Prefix:
First Name:KERRI
Middle Name:KELLESIA
Last Name:AMRITT
Suffix:
Gender:F
Credentials:MS SLP
Other - Prefix:MRS
Other - First Name:KERRI
Other - Middle Name:KELLESIA
Other - Last Name:AMRITT-BOOTA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS SLP
Mailing Address - Street 1:3335 N UNIVERSITY DR
Mailing Address - Street 2:SUITE 5
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33024-2200
Mailing Address - Country:US
Mailing Address - Phone:954-442-9422
Mailing Address - Fax:954-442-9150
Practice Address - Street 1:3335 N UNIVERSITY DR
Practice Address - Street 2:SUITE 5
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33024-2200
Practice Address - Country:US
Practice Address - Phone:954-442-9422
Practice Address - Fax:954-442-9150
Is Sole Proprietor?:No
Enumeration Date:2013-01-31
Last Update Date:2013-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSZ6120235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist