Provider Demographics
NPI:1366288458
Name:DELISI, KELLY NICOLE (CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:KELLY
Middle Name:NICOLE
Last Name:DELISI
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:MS
Other - First Name:KELLY
Other - Middle Name:NICOLE
Other - Last Name:STROHAUER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CCC-SLP
Mailing Address - Street 1:15682 THORNWOOD DR
Mailing Address - Street 2:
Mailing Address - City:FINDLAY
Mailing Address - State:OH
Mailing Address - Zip Code:45840-9765
Mailing Address - Country:US
Mailing Address - Phone:586-295-2654
Mailing Address - Fax:
Practice Address - Street 1:182 SAINT FRANCIS AVE
Practice Address - Street 2:
Practice Address - City:TIFFIN
Practice Address - State:OH
Practice Address - Zip Code:44883-3456
Practice Address - Country:US
Practice Address - Phone:419-447-2723
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-08
Last Update Date:2024-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP.15792235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist