Provider Demographics
NPI:1831395037
Name:KELLY, VALERIE MARIE (MS CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:VALERIE
Middle Name:MARIE
Last Name:KELLY
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:MRS
Other - First Name:VALERIE
Other - Middle Name:
Other - Last Name:BRIER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:12933 SUMMIT RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63146-4337
Mailing Address - Country:US
Mailing Address - Phone:314-223-6535
Mailing Address - Fax:314-317-9904
Practice Address - Street 1:12933 SUMMIT RIDGE DR
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63146-4337
Practice Address - Country:US
Practice Address - Phone:314-223-6535
Practice Address - Fax:314-317-9904
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2000163878235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist