Provider Demographics
NPI:1801106422
Name:GALVAN, KELLY ANN (MS -SPEECH PATHOLOGY)
Entity type:Individual
Prefix:MRS
First Name:KELLY
Middle Name:ANN
Last Name:GALVAN
Suffix:
Gender:F
Credentials:MS -SPEECH PATHOLOGY
Other - Prefix:MS
Other - First Name:KELLY
Other - Middle Name:ANN
Other - Last Name:MARSHALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS -SPEECH PATHOLOGY
Mailing Address - Street 1:8320 CINNAMON RIDGE LN
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89523-4836
Mailing Address - Country:US
Mailing Address - Phone:775-250-4832
Mailing Address - Fax:
Practice Address - Street 1:1025 ROBERTA LN
Practice Address - Street 2:
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89431-1893
Practice Address - Country:US
Practice Address - Phone:775-825-4744
Practice Address - Fax:775-351-1644
Is Sole Proprietor?:No
Enumeration Date:2010-10-16
Last Update Date:2010-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVSP-1339235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist