Provider Demographics
NPI:1205144896
Name:LAFALCE, KELLY (MA, CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:KELLY
Middle Name:
Last Name:LAFALCE
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 1:50 DELAFIELD STREET
Mailing Address - Street 2:ASTOR SERVICES FOR CHILDREN AND FAMILIES
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12601-1707
Mailing Address - Country:US
Mailing Address - Phone:845-452-4167
Mailing Address - Fax:845-452-0833
Practice Address - Street 1:50 DELAFIELD STREET
Practice Address - Street 2:ASTOR SERVICES FOR CHILDREN AND FAMILIES
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12601-1707
Practice Address - Country:US
Practice Address - Phone:845-452-4167
Practice Address - Fax:845-452-0833
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-17
Last Update Date:2010-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010724-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist