Provider Demographics
NPI:1770996639
Name:FLYNN, KELLI-ANN (MS, CF-SLP)
Entity type:Individual
Prefix:MS
First Name:KELLI-ANN
Middle Name:
Last Name:FLYNN
Suffix:
Gender:F
Credentials:MS, CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7030 SMOKE RANCH RD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-1202
Mailing Address - Country:US
Mailing Address - Phone:702-979-4268
Mailing Address - Fax:
Practice Address - Street 1:7030 SMOKE RANCH RD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-1202
Practice Address - Country:US
Practice Address - Phone:702-979-4268
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-09
Last Update Date:2014-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVSP-1707235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist