Provider Demographics
NPI:1225276116
Name:MOREL, KELLY A III (MA, CCC-SLP/TSSLD)
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:A
Last Name:MOREL
Suffix:III
Gender:F
Credentials:MA, CCC-SLP/TSSLD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25311 87TH AVE
Mailing Address - Street 2:
Mailing Address - City:BELLEROSE
Mailing Address - State:NY
Mailing Address - Zip Code:11426-2416
Mailing Address - Country:US
Mailing Address - Phone:347-231-6832
Mailing Address - Fax:718-413-4803
Practice Address - Street 1:253-11 87TH AVE
Practice Address - Street 2:
Practice Address - City:BELLEROSE
Practice Address - State:NY
Practice Address - Zip Code:11426
Practice Address - Country:US
Practice Address - Phone:347-231-6832
Practice Address - Fax:718-413-4803
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-30
Last Update Date:2009-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016454-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist