Provider Demographics
NPI:1407169410
Name:GLYNN, KALI ELIZABETH (SPEECH THERAPIST)
Entity Type:Individual
Prefix:
First Name:KALI
Middle Name:ELIZABETH
Last Name:GLYNN
Suffix:
Gender:F
Credentials:SPEECH THERAPIST
Other - Prefix:
Other - First Name:KALI
Other - Middle Name:ELIZABETH
Other - Last Name:WHITE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:16030 BOTHELL EVERETT HWY STE 140
Mailing Address - Street 2:
Mailing Address - City:MILL CREEK
Mailing Address - State:WA
Mailing Address - Zip Code:98012-1273
Mailing Address - Country:US
Mailing Address - Phone:425-338-9005
Mailing Address - Fax:425-337-0931
Practice Address - Street 1:16030 BOTHELL EVERETT HWY STE 140
Practice Address - Street 2:
Practice Address - City:MILL CREEK
Practice Address - State:WA
Practice Address - Zip Code:98012-1273
Practice Address - Country:US
Practice Address - Phone:425-338-9005
Practice Address - Fax:425-337-0931
Is Sole Proprietor?:No
Enumeration Date:2010-07-19
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALL00004438235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist