Provider Demographics
NPI:1740687714
Name:MONTCHAI, KELLY MAUREEN (MA, SLP-CCC)
Entity type:Individual
Prefix:
First Name:KELLY
Middle Name:MAUREEN
Last Name:MONTCHAI
Suffix:
Gender:F
Credentials:MA, SLP-CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3240 BANNING RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45239-5207
Mailing Address - Country:US
Mailing Address - Phone:513-385-8000
Mailing Address - Fax:513-385-8090
Practice Address - Street 1:3240 BANNING RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45239-5207
Practice Address - Country:US
Practice Address - Phone:513-385-8000
Practice Address - Fax:513-385-8090
Is Sole Proprietor?:No
Enumeration Date:2014-11-19
Last Update Date:2014-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP4676235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist