Provider Demographics
NPI:1821223132
Name:GALMON, KEISIA NANETTE (CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:KEISIA
Middle Name:NANETTE
Last Name:GALMON
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:MS
Other - First Name:KEISIA
Other - Middle Name:NANETTE
Other - Last Name:GALMON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CCC-SLP
Mailing Address - Street 1:2656 SOUTH LOOP WEST
Mailing Address - Street 2:170
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-2673
Mailing Address - Country:US
Mailing Address - Phone:404-668-0170
Mailing Address - Fax:800-956-9786
Practice Address - Street 1:2656 S LOOP W STE 440
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-2697
Practice Address - Country:US
Practice Address - Phone:281-972-0442
Practice Address - Fax:800-956-9786
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-16
Last Update Date:2019-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP006065235Z00000X
TX106563235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist