Provider Demographics
NPI:1558102384
Name:RANIERO, KELLY
Entity type:Individual
Prefix:
First Name:KELLY
Middle Name:
Last Name:RANIERO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:975 FICKES RD
Mailing Address - Street 2:
Mailing Address - City:DILLSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17019-9653
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4813 JONESTOWN RD STE 107
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17109-1700
Practice Address - Country:US
Practice Address - Phone:717-545-1031
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-05
Last Update Date:2024-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAFO3895237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist