Provider Demographics
NPI:1689316580
Name:KINCHELOE, HARLEY BELLE (MS, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:HARLEY
Middle Name:BELLE
Last Name:KINCHELOE
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 1:1521 GULCH ST
Mailing Address - Street 2:
Mailing Address - City:CODY
Mailing Address - State:WY
Mailing Address - Zip Code:82414-9335
Mailing Address - Country:US
Mailing Address - Phone:406-861-8021
Mailing Address - Fax:
Practice Address - Street 1:919 CODY AVE
Practice Address - Street 2:
Practice Address - City:CODY
Practice Address - State:WY
Practice Address - Zip Code:82414-4115
Practice Address - Country:US
Practice Address - Phone:307-587-4251
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-11
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYSP-1220235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist