Provider Demographics
NPI:1568181378
Name:MCKELLAR, AMBER LEIGH
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:LEIGH
Last Name:MCKELLAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1607 BLOSSOM CREEK CT
Mailing Address - Street 2:
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77339-3075
Mailing Address - Country:US
Mailing Address - Phone:936-327-6061
Mailing Address - Fax:
Practice Address - Street 1:1800 TRAILWOOD VILLAGE DR
Practice Address - Street 2:
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339-3306
Practice Address - Country:US
Practice Address - Phone:281-641-1475
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-24
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX114732235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist