Provider Demographics
NPI:1831945146
Name:CEDOR, KELLY (AUD)
Entity type:Individual
Prefix:DR
First Name:KELLY
Middle Name:
Last Name:CEDOR
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:291 FLETCHER RD
Mailing Address - Street 2:
Mailing Address - City:NORTH KINGSTOWN
Mailing Address - State:RI
Mailing Address - Zip Code:02852-1608
Mailing Address - Country:US
Mailing Address - Phone:401-714-1968
Mailing Address - Fax:
Practice Address - Street 1:6 BLACKSTONE VALLEY PL STE 510
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:RI
Practice Address - Zip Code:02865-1102
Practice Address - Country:US
Practice Address - Phone:401-714-1968
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-26
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIAUD00103237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter