Provider Demographics
NPI:1184800906
Name:RICH, KELLI FARR (MA CCC-SLP)
Entity type:Individual
Prefix:
First Name:KELLI
Middle Name:FARR
Last Name:RICH
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:243 BLUE HILLS DR
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37214-2740
Mailing Address - Country:US
Mailing Address - Phone:615-604-0482
Mailing Address - Fax:
Practice Address - Street 1:243 BLUE HILLS DR
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37214-2740
Practice Address - Country:US
Practice Address - Phone:615-604-0482
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-10
Last Update Date:2008-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3188235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist