Provider Demographics
NPI:1871481838
Name:RATTIGAN, KELLY NICOLE (MS)
Entity type:Individual
Prefix:
First Name:KELLY
Middle Name:NICOLE
Last Name:RATTIGAN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:84 BRANDY LN
Mailing Address - Street 2:
Mailing Address - City:WAPPINGERS FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12590-6445
Mailing Address - Country:US
Mailing Address - Phone:845-392-7660
Mailing Address - Fax:
Practice Address - Street 1:84 BRANDY LN
Practice Address - Street 2:
Practice Address - City:WAPPINGERS FALLS
Practice Address - State:NY
Practice Address - Zip Code:12590-6445
Practice Address - Country:US
Practice Address - Phone:845-392-7660
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-26
Last Update Date:2025-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist