Provider Demographics
NPI:1598377848
Name:ALFORD, KEILETTIA MICHELLE (MS,CF-SLP)
Entity Type:Individual
Prefix:
First Name:KEILETTIA
Middle Name:MICHELLE
Last Name:ALFORD
Suffix:
Gender:F
Credentials:MS,CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5702 SARGENT RD
Mailing Address - Street 2:
Mailing Address - City:CHILLUM
Mailing Address - State:MD
Mailing Address - Zip Code:20782-2321
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5702 SARGENT RD
Practice Address - Street 2:
Practice Address - City:CHILLUM
Practice Address - State:MD
Practice Address - Zip Code:20782-2321
Practice Address - Country:US
Practice Address - Phone:301-853-7370
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-18
Last Update Date:2020-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist