Provider Demographics
NPI:1710758370
Name:HULIT, KELSI
Entity Type:Individual
Prefix:
First Name:KELSI
Middle Name:
Last Name:HULIT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7041 AVALON RD NW
Mailing Address - Street 2:
Mailing Address - City:MALVERN
Mailing Address - State:OH
Mailing Address - Zip Code:44644-9743
Mailing Address - Country:US
Mailing Address - Phone:330-418-2192
Mailing Address - Fax:
Practice Address - Street 1:406 EAST ST
Practice Address - Street 2:
Practice Address - City:MINERVA
Practice Address - State:OH
Practice Address - Zip Code:44657-1429
Practice Address - Country:US
Practice Address - Phone:330-868-4011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-12
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOND.20232629-SP235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist