Provider Demographics
NPI:1528584158
Name:MUNDAY, KELSEY D (SLP)
Entity Type:Individual
Prefix:
First Name:KELSEY
Middle Name:D
Last Name:MUNDAY
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:KELSEY
Other - Middle Name:D
Other - Last Name:FISHER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2850 WESTOWN PKWY
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-1301
Mailing Address - Country:US
Mailing Address - Phone:515-224-5225
Mailing Address - Fax:515-224-5235
Practice Address - Street 1:2850 WESTOWN PKWY
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-1301
Practice Address - Country:US
Practice Address - Phone:515-224-5225
Practice Address - Fax:515-224-5235
Is Sole Proprietor?:No
Enumeration Date:2017-08-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA002357235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist