Provider Demographics
NPI:1821330457
Name:GALLOWAY, KELLY KIRVEN (SLP)
Entity Type:Individual
Prefix:MRS
First Name:KELLY
Middle Name:KIRVEN
Last Name:GALLOWAY
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2021 TIMMONSVILLE HWY
Mailing Address - Street 2:
Mailing Address - City:DARLINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29532-7511
Mailing Address - Country:US
Mailing Address - Phone:843-398-0988
Mailing Address - Fax:
Practice Address - Street 1:515 N CASHUA DR
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29501-2003
Practice Address - Country:US
Practice Address - Phone:843-664-8156
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-21
Last Update Date:2013-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3870235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist