Provider Demographics
NPI:1124576905
Name:SKORZEWSKI, KELSEY LOVINE
Entity Type:Individual
Prefix:
First Name:KELSEY
Middle Name:LOVINE
Last Name:SKORZEWSKI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 HICKORY MEADOW RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29072-8876
Mailing Address - Country:US
Mailing Address - Phone:803-391-2603
Mailing Address - Fax:
Practice Address - Street 1:141 HICKORY MEADOW RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:SC
Practice Address - Zip Code:29072-8876
Practice Address - Country:US
Practice Address - Phone:803-391-2603
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-21
Last Update Date:2023-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC6070235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist