Provider Demographics
NPI:1679853576
Name:EDLING, KELLI (MS CCCSLP)
Entity Type:Individual
Prefix:
First Name:KELLI
Middle Name:
Last Name:EDLING
Suffix:
Gender:F
Credentials:MS CCCSLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 HORSHAM RD
Mailing Address - Street 2:
Mailing Address - City:HORSHAM
Mailing Address - State:PA
Mailing Address - Zip Code:19044-1209
Mailing Address - Country:US
Mailing Address - Phone:267-255-3832
Mailing Address - Fax:
Practice Address - Street 1:801 HORSHAM RD
Practice Address - Street 2:
Practice Address - City:HORSHAM
Practice Address - State:PA
Practice Address - Zip Code:19044-1209
Practice Address - Country:US
Practice Address - Phone:267-255-3832
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-23
Last Update Date:2019-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL004223L235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist