Provider Demographics
NPI:1548816705
Name:SALISBURY, KAYLEE RACHELLE (CF- SLP)
Entity type:Individual
Prefix:
First Name:KAYLEE
Middle Name:RACHELLE
Last Name:SALISBURY
Suffix:
Gender:F
Credentials:CF- SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11049 OAK SPUR CT APT G
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63146-1971
Mailing Address - Country:US
Mailing Address - Phone:616-886-2080
Mailing Address - Fax:
Practice Address - Street 1:3601 DROSTE RD
Practice Address - Street 2:
Practice Address - City:SAINT CHARLES
Practice Address - State:MO
Practice Address - Zip Code:63301-1125
Practice Address - Country:US
Practice Address - Phone:636-443-4200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-14
Last Update Date:2019-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist