Provider Demographics
NPI:1669290805
Name:DEPODESTA, KEILIE (CF-SLP)
Entity type:Individual
Prefix:MRS
First Name:KEILIE
Middle Name:
Last Name:DEPODESTA
Suffix:
Gender:F
Credentials:CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:451 STATE ST APT 2
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12203-1054
Mailing Address - Country:US
Mailing Address - Phone:518-301-3680
Mailing Address - Fax:
Practice Address - Street 1:55 HELPING HAND LN
Practice Address - Street 2:
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12302-5801
Practice Address - Country:US
Practice Address - Phone:518-384-3043
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-27
Last Update Date:2024-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist