Fairris, Kelly Ann
Fairris, Kelly Ann is an individual health care provider with primary practice located at 440 Edmond Dr , Dyer IN 46311-1523. She recently has only one registered license in Speech, Language and Hearing Service Providers / Speech-Language Pathologist, which is considered as her primary health care specialty. Fairris, Kelly Ann can be contacted via phone (219) 322-1415.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Speech, Language and Hearing Service Providers / Speech-Language Pathologist | 235Z00000X | 22004186A | Indiana |
Profile Details
| NPI number | 1104884378 |
|---|---|
| LBN Legal business name | Fairris, Kelly Ann |
| Credentials | MA CCC SLP |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 3rd, 2006 |
| Last updated | Sep 30th, 2021 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1104884378 | NPPES |
| Indiana | MEDICAID | 200683490 |
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