Provider Demographics
NPI:1760827083
Name:TWEHUES, KELLY CRAWFORD (SLP)
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:CRAWFORD
Last Name:TWEHUES
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:KELLY
Other - Middle Name:JEAN
Other - Last Name:CRAWFORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:18 N FORT THOMAS AVE STE 302
Mailing Address - Street 2:
Mailing Address - City:FORT THOMAS
Mailing Address - State:KY
Mailing Address - Zip Code:41075-1595
Mailing Address - Country:US
Mailing Address - Phone:859-441-0139
Mailing Address - Fax:
Practice Address - Street 1:18 N FORT THOMAS AVE STE 302
Practice Address - Street 2:
Practice Address - City:FORT THOMAS
Practice Address - State:KY
Practice Address - Zip Code:41075-1595
Practice Address - Country:US
Practice Address - Phone:859-441-0139
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-30
Last Update Date:2022-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY3470235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist