Provider Demographics
NPI:1225713431
Name:TRUAX, KELLEE (HIS)
Entity Type:Individual
Prefix:
First Name:KELLEE
Middle Name:
Last Name:TRUAX
Suffix:
Gender:F
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 PROSPECT AVE # 102
Mailing Address - Street 2:
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21742-3204
Mailing Address - Country:US
Mailing Address - Phone:301-790-3300
Mailing Address - Fax:
Practice Address - Street 1:201 PROSPECT AVE # 102
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21742-3204
Practice Address - Country:US
Practice Address - Phone:301-790-3300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-16
Last Update Date:2023-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD02923237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist