Provider Demographics
NPI:1275971723
Name:GALLOWAY, KELLY OWENS (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:OWENS
Last Name:GALLOWAY
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:226 ROPER RD
Mailing Address - Street 2:
Mailing Address - City:PIEDMONT
Mailing Address - State:SC
Mailing Address - Zip Code:29673-8431
Mailing Address - Country:US
Mailing Address - Phone:864-850-5950
Mailing Address - Fax:864-850-5951
Practice Address - Street 1:226 ROPER RD
Practice Address - Street 2:
Practice Address - City:PIEDMONT
Practice Address - State:SC
Practice Address - Zip Code:29673-8431
Practice Address - Country:US
Practice Address - Phone:864-850-5950
Practice Address - Fax:864-850-5951
Is Sole Proprietor?:No
Enumeration Date:2013-06-06
Last Update Date:2013-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3196235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist