Provider Demographics
NPI:1740049592
Name:HOAK, KELLY LYNN (SLP)
Entity type:Individual
Prefix:
First Name:KELLY
Middle Name:LYNN
Last Name:HOAK
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:KELLY
Other - Middle Name:LYNN
Other - Last Name:SOMMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:429 SHOGAN DR
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-5710
Mailing Address - Country:US
Mailing Address - Phone:724-809-4115
Mailing Address - Fax:
Practice Address - Street 1:890 WEATHERWOOD LN
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-5777
Practice Address - Country:US
Practice Address - Phone:724-837-8076
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-14
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL014764235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist