Provider Demographics
NPI:1730478397
Name:MARION, KELLY (MS, SLP-CCC)
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:
Last Name:MARION
Suffix:
Gender:F
Credentials:MS, SLP-CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1805 LOUCKS RD
Mailing Address - Street 2:SUITE 800
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17408-7902
Mailing Address - Country:US
Mailing Address - Phone:717-885-0063
Mailing Address - Fax:
Practice Address - Street 1:1805 LOUCKS RD
Practice Address - Street 2:SUITE 800
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17408-7902
Practice Address - Country:US
Practice Address - Phone:717-885-0063
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-05
Last Update Date:2012-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL010330235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist