Provider Demographics
NPI:1558102210
Name:PELFREY, KALEY LAUREN (MSAT, ATC, LAT)
Entity type:Individual
Prefix:
First Name:KALEY
Middle Name:LAUREN
Last Name:PELFREY
Suffix:
Gender:F
Credentials:MSAT, ATC, LAT
Other - Prefix:
Other - First Name:KALEY
Other - Middle Name:LAUREN
Other - Last Name:COOK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:408 E OAK ST
Mailing Address - Street 2:
Mailing Address - City:ALEDO
Mailing Address - State:TX
Mailing Address - Zip Code:76008-4342
Mailing Address - Country:US
Mailing Address - Phone:503-851-9343
Mailing Address - Fax:
Practice Address - Street 1:408 E OAK ST
Practice Address - Street 2:
Practice Address - City:ALEDO
Practice Address - State:TX
Practice Address - Zip Code:76008-4342
Practice Address - Country:US
Practice Address - Phone:503-851-9343
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-05
Last Update Date:2024-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAT97762255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer