Most Relevant Information
Provider Data
| NPI Number: | 1003297680 |
| Provider Name: | KELLI DOUGLAS M.A. CCC-SLP |
| Entity Type: | Individual |
| Taxonomy Code: | 235Z00000X |
| Specialty: | Speech-Language Pathologist |
| License Number: | 3800 |
Most Important Dates
| Enumeration Date: | 06/09/2015 |
| Last Updated: | 03/20/2019 |
Provider Practice Location
3901 RAINBOW BLVD
KANSAS CITY
KS
661608500
Practice Location Phone/Fax
| Phone: | 9135886745 |
| Fax: | 9135884676 |
Provider Mailing Location
PO BOX 411851
KANSAS CITY
MO
641411851
Provider Mailing Phone/Fax
| Phone: | 9135886701 |
| Fax: | 9135886677 |