Provider Demographics
NPI:1639729734
Name:ALAMO, KELSEA VICTORIA (MA, CCC-SLP)
Entity type:Individual
Prefix:
First Name:KELSEA
Middle Name:VICTORIA
Last Name:ALAMO
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 1:1707 CADDO CIR
Mailing Address - Street 2:
Mailing Address - City:DALHART
Mailing Address - State:TX
Mailing Address - Zip Code:79022-5117
Mailing Address - Country:US
Mailing Address - Phone:209-534-1664
Mailing Address - Fax:
Practice Address - Street 1:1115 NORTHERN DANCER DR
Practice Address - Street 2:
Practice Address - City:COPPERAS COVE
Practice Address - State:TX
Practice Address - Zip Code:76522-4789
Practice Address - Country:US
Practice Address - Phone:806-244-0015
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-19
Last Update Date:2024-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX116259235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist