Provider Demographics
NPI:1669661518
Name:KERNER, KELLI MARGARET (MA CCC/SLP)
Entity Type:Individual
Prefix:
First Name:KELLI
Middle Name:MARGARET
Last Name:KERNER
Suffix:
Gender:F
Credentials:MA CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4602 DAVID DR
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:PA
Mailing Address - Zip Code:19007-2016
Mailing Address - Country:US
Mailing Address - Phone:215-826-8583
Mailing Address - Fax:
Practice Address - Street 1:151 BUSTLETON PIKE
Practice Address - Street 2:GROUND FLOOR
Practice Address - City:FEASTERVILLE TREVOSE
Practice Address - State:PA
Practice Address - Zip Code:19053-6456
Practice Address - Country:US
Practice Address - Phone:215-357-3048
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-16
Last Update Date:2007-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL007959235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist