Provider Demographics
NPI:1679762454
Name:KELLEY, SARAH CASEY (AUD)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:CASEY
Last Name:KELLEY
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:DR
Other - First Name:SARAH
Other - Middle Name:
Other - Last Name:CASEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:885 SOUTH PARSONS AVE
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511
Mailing Address - Country:US
Mailing Address - Phone:813-436-5900
Mailing Address - Fax:813-262-1335
Practice Address - Street 1:885 SOUTH PARSONS AVE
Practice Address - Street 2:ALL CHILDREN'S OUTPATIENT CARE
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511
Practice Address - Country:US
Practice Address - Phone:813-436-5900
Practice Address - Fax:813-262-1335
Is Sole Proprietor?:No
Enumeration Date:2007-10-17
Last Update Date:2013-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY1327231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist