Provider Demographics
NPI:1932479466
Name:PELPHREY, VICKY LEE (MA, CCC/SLP)
Entity Type:Individual
Prefix:
First Name:VICKY
Middle Name:LEE
Last Name:PELPHREY
Suffix:
Gender:F
Credentials:MA, CCC/SLP
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Other - Credentials:
Mailing Address - Street 1:516 TAMIAMI TRL S UNIT 306
Mailing Address - Street 2:HARBOR VILLAS AT DONA BAY
Mailing Address - City:NOKOMIS
Mailing Address - State:FL
Mailing Address - Zip Code:34275-3184
Mailing Address - Country:US
Mailing Address - Phone:941-376-0560
Mailing Address - Fax:941-296-7476
Practice Address - Street 1:516 TAMIAMI TRL S UNIT 306
Practice Address - Street 2:HARBOR VILLAS AT DONA BAY
Practice Address - City:NOKOMIS
Practice Address - State:FL
Practice Address - Zip Code:34275-3184
Practice Address - Country:US
Practice Address - Phone:941-376-0560
Practice Address - Fax:941-296-7476
Is Sole Proprietor?:No
Enumeration Date:2011-12-30
Last Update Date:2011-12-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLSA5952235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist