Provider Demographics
NPI:1770775918
Name:VOISEY, KELLY LYNN (MS CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:KELLY
Middle Name:LYNN
Last Name:VOISEY
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:MRS
Other - First Name:KELLY
Other - Middle Name:T
Other - Last Name:VOISEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS CCC-SLP
Mailing Address - Street 1:2019 AVALON MIST CIR
Mailing Address - Street 2:
Mailing Address - City:DARDENNE PRAIRIE
Mailing Address - State:MO
Mailing Address - Zip Code:63368-7336
Mailing Address - Country:US
Mailing Address - Phone:636-294-4566
Mailing Address - Fax:636-294-4566
Practice Address - Street 1:2019 AVALON MIST CIR
Practice Address - Street 2:
Practice Address - City:DARDENNE PRAIRIE
Practice Address - State:MO
Practice Address - Zip Code:63368-7336
Practice Address - Country:US
Practice Address - Phone:636-294-4566
Practice Address - Fax:636-294-4566
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-12
Last Update Date:2007-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2001009695235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO2001009695OtherSTATE LICENSE