Provider Demographics
NPI:1568843852
Name:BREESE, KELLY ELIZABETH (AUD)
Entity Type:Individual
Prefix:DR
First Name:KELLY
Middle Name:ELIZABETH
Last Name:BREESE
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:KELLY
Other - Middle Name:E
Other - Last Name:MURPHY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MURPHY
Mailing Address - Street 1:2085 SIESTA DR STE 3
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239-5201
Mailing Address - Country:US
Mailing Address - Phone:941-366-2240
Mailing Address - Fax:941-312-5602
Practice Address - Street 1:2085 SIESTA DR STE 3
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-5201
Practice Address - Country:US
Practice Address - Phone:941-366-2240
Practice Address - Fax:941-312-5602
Is Sole Proprietor?:No
Enumeration Date:2015-06-12
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY1950231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist