Individual provider · NPI-1

Kelly Bush, MS SLP-CCC

Speech-Language Pathologist, · Palm Beach Gardens, FL

NPI number1114308806
StatusActive
Last updated in NPPESJun 18, 2015

Details

NPI
1114308806
Entity type
Individual (NPI-1)
Name
Kelly Bush
Credential
MS SLP-CCC
Sex
Female
Sole proprietor
Yes
Enumeration date
Jun 18, 2015
Last updated
Jun 18, 2015

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
235Z00000X Speech-Language Pathologist,SA171FLYes

Practice location

203 E Tall Oaks Cir
Palm Beach Gardens, FL 33410-4451

Phone 561-847-1663

Mailing address

203 E Tall Oaks Cir
Palm Beach Gardens, FL 33410-4451

Phone 561-847-1663

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