Provider Demographics
NPI:1720865926
Name:MCGREGOR, KELSEY (MS)
Entity Type:Individual
Prefix:
First Name:KELSEY
Middle Name:
Last Name:MCGREGOR
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 MCBRIDE RD
Mailing Address - Street 2:
Mailing Address - City:LITCHFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06759-3812
Mailing Address - Country:US
Mailing Address - Phone:860-921-3186
Mailing Address - Fax:
Practice Address - Street 1:1389 W MAIN ST STE 225
Practice Address - Street 2:
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06708-3115
Practice Address - Country:US
Practice Address - Phone:203-757-1474
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-11
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT007450235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist