Provider Demographics
NPI:1801326210
Name:MAZUR, KELSEY ELIZABETH (MA CF- SLP)
Entity type:Individual
Prefix:MS
First Name:KELSEY
Middle Name:ELIZABETH
Last Name:MAZUR
Suffix:
Gender:F
Credentials:MA CF- SLP
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Mailing Address - Street 1:1051 JOHNNIE DODDS BLVD STE G
Mailing Address - Street 2:
Mailing Address - City:MT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-3100
Mailing Address - Country:US
Mailing Address - Phone:843-300-2812
Mailing Address - Fax:843-480-9844
Practice Address - Street 1:1051 JOHNNIE DODDS BLVD STE G
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-3100
Practice Address - Country:US
Practice Address - Phone:843-300-2812
Practice Address - Fax:843-480-9844
Is Sole Proprietor?:No
Enumeration Date:2017-06-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SC6250235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist