Provider Demographics
NPI:1366751794
Name:SMITH VERNON, KELLY SUE (MA)
Entity type:Individual
Prefix:MRS
First Name:KELLY
Middle Name:SUE
Last Name:SMITH VERNON
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
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Mailing Address - Street 1:1350 PLEASANT HILL RD
Mailing Address - Street 2:
Mailing Address - City:GALLIPOLIS
Mailing Address - State:OH
Mailing Address - Zip Code:45631-9074
Mailing Address - Country:US
Mailing Address - Phone:740-379-9175
Mailing Address - Fax:
Practice Address - Street 1:4836 STATE ROUTE 325
Practice Address - Street 2:
Practice Address - City:PATRIOT
Practice Address - State:OH
Practice Address - Zip Code:45658-8960
Practice Address - Country:US
Practice Address - Phone:740-379-9085
Practice Address - Fax:740-379-9138
Is Sole Proprietor?:No
Enumeration Date:2010-10-04
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist