Provider Demographics
NPI:1871937052
Name:NABER, KELSEY R (SLP)
Entity type:Individual
Prefix:
First Name:KELSEY
Middle Name:R
Last Name:NABER
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7354 COLGATE AVE
Mailing Address - Street 2:
Mailing Address - City:UNIVERSITY CITY
Mailing Address - State:MO
Mailing Address - Zip Code:63130-2931
Mailing Address - Country:US
Mailing Address - Phone:314-339-7732
Mailing Address - Fax:
Practice Address - Street 1:1170 TIMBER RUN DR
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63146
Practice Address - Country:US
Practice Address - Phone:314-469-0606
Practice Address - Fax:314-469-3294
Is Sole Proprietor?:No
Enumeration Date:2013-04-18
Last Update Date:2018-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2012041760235Z00000X
MO2013045568235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist