Provider Demographics
NPI:1386191518
Name:KELLY, MARGARET T (CCC/SLP)
Entity Type:Individual
Prefix:MS
First Name:MARGARET
Middle Name:T
Last Name:KELLY
Suffix:
Gender:F
Credentials:CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:81 QUINCY DR
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03110-5021
Mailing Address - Country:US
Mailing Address - Phone:603-502-7747
Mailing Address - Fax:
Practice Address - Street 1:519 BRIDGE ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03104-5396
Practice Address - Country:US
Practice Address - Phone:603-668-2373
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-06
Last Update Date:2021-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1555235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist