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KELLY L OTT
>> Speech-Language Pathologist >> Speech, Language and Hearing Service ProvidersRegistrant NPI Number: 1831404391
Individual Registrant: KELLY L OTT
Gender: F
Sole Proprietor
Gender: F
Sole Proprietor
Location and contact information for practice:
12466 HIGHWAY 24 MADISON, MO 65263-2150 US
Tel: 660-291-8102 Fax: 660-291-5338
Tel: 660-291-8102 Fax: 660-291-5338
Contact information for business:
12466 HIGHWAY 24 MADISON, MO 65263-2150 US
Tel: -- Fax: --
Tel: -- Fax: --
Registration Information:
NPI: 1831404391
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 235Z00000X | Speech, Language and Hearing Service Providers Speech-Language Pathologist | MO | HE108783 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
