Provider Demographics
NPI:1801235643
Name:WARD, KELSIE MARIE (MED, CCC-SLP)
Entity type:Individual
Prefix:MISS
First Name:KELSIE
Middle Name:MARIE
Last Name:WARD
Suffix:
Gender:F
Credentials:MED, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:286 MARIONS WAY
Mailing Address - Street 2:
Mailing Address - City:FELTON
Mailing Address - State:DE
Mailing Address - Zip Code:19943-5238
Mailing Address - Country:US
Mailing Address - Phone:302-538-8397
Mailing Address - Fax:
Practice Address - Street 1:286 MARIONS WAY
Practice Address - Street 2:
Practice Address - City:FELTON
Practice Address - State:DE
Practice Address - Zip Code:19943-5238
Practice Address - Country:US
Practice Address - Phone:302-538-8397
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-14
Last Update Date:2015-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
235Z00000X
NC1403034235Z00000X
DEO1-0001431235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist