Provider Demographics
NPI:1629504824
Name:SAVARD, KELLIE (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:KELLIE
Middle Name:
Last Name:SAVARD
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 662
Mailing Address - Street 2:UNIT B
Mailing Address - City:BURGAW
Mailing Address - State:NC
Mailing Address - Zip Code:28425-0662
Mailing Address - Country:US
Mailing Address - Phone:910-228-3449
Mailing Address - Fax:844-803-6048
Practice Address - Street 1:213 SOUTH WRIGHT STREET
Practice Address - Street 2:UNIT B
Practice Address - City:BURGAW
Practice Address - State:NC
Practice Address - Zip Code:28425
Practice Address - Country:US
Practice Address - Phone:910-300-6150
Practice Address - Fax:844-803-6048
Is Sole Proprietor?:No
Enumeration Date:2017-05-08
Last Update Date:2017-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5969235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist