Provider Demographics
NPI:1598295743
Name:KNEPPER, KELLY
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:
Last Name:KNEPPER
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 1:522 BEAVER ST REAR
Mailing Address - Street 2:
Mailing Address - City:SEWICKLEY
Mailing Address - State:PA
Mailing Address - Zip Code:15143-1779
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:837 EVANS CITY RD STE 101
Practice Address - Street 2:
Practice Address - City:RENFREW
Practice Address - State:PA
Practice Address - Zip Code:16053-9213
Practice Address - Country:US
Practice Address - Phone:724-486-3077
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-19
Last Update Date:2017-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist