Provider Demographics
NPI:1649713116
Name:ZARIFA, KELLY
Entity type:Individual
Prefix:
First Name:KELLY
Middle Name:
Last Name:ZARIFA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10233 MILLSTONE DR
Mailing Address - Street 2:APT#4205
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66220-2717
Mailing Address - Country:US
Mailing Address - Phone:316-461-5946
Mailing Address - Fax:
Practice Address - Street 1:21250 W 151ST ST
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66061-8100
Practice Address - Country:US
Practice Address - Phone:913-390-0444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-30
Last Update Date:2016-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS3548235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist