Provider Demographics
NPI:1376835314
Name:DELSIGNORE, KELLY (MSCCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:KELLY
Middle Name:
Last Name:DELSIGNORE
Suffix:
Gender:F
Credentials:MSCCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 RICCIUTI DR
Mailing Address - Street 2:APT 1724
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02169-6287
Mailing Address - Country:US
Mailing Address - Phone:617-365-3387
Mailing Address - Fax:
Practice Address - Street 1:333 RICCIUTI DR
Practice Address - Street 2:APT 1724
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02169-6287
Practice Address - Country:US
Practice Address - Phone:617-365-3387
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-10
Last Update Date:2011-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7590235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist