Provider Demographics
NPI:1346676087
Name:FLAHERTY, KELLY (AUD)
Entity Type:Individual
Prefix:DR
First Name:KELLY
Middle Name:
Last Name:FLAHERTY
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 S VALLEY RD
Mailing Address - Street 2:SUITE 206
Mailing Address - City:PAOLI
Mailing Address - State:PA
Mailing Address - Zip Code:19301-1450
Mailing Address - Country:US
Mailing Address - Phone:610-296-5857
Mailing Address - Fax:
Practice Address - Street 1:2205 SILVERSIDE RD STE 4
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19810-4534
Practice Address - Country:US
Practice Address - Phone:302-529-9103
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-25
Last Update Date:2020-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAT006314231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist