Provider Demographics
NPI:1740465749
Name:KELKENBERG, HOPE (CCC/L-SLP)
Entity type:Individual
Prefix:
First Name:HOPE
Middle Name:
Last Name:KELKENBERG
Suffix:
Gender:F
Credentials:CCC/L-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 HOAG AVE
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:NY
Mailing Address - Zip Code:14001-1124
Mailing Address - Country:US
Mailing Address - Phone:716-225-0061
Mailing Address - Fax:
Practice Address - Street 1:42 HOAG AVE
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:NY
Practice Address - Zip Code:14001-1124
Practice Address - Country:US
Practice Address - Phone:716-225-0061
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-08
Last Update Date:2008-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017467235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist