Provider Demographics
NPI:1861974248
Name:BROWN, KELSEY FRITSCHER (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:KELSEY
Middle Name:FRITSCHER
Last Name:BROWN
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:424 E JOHNSON ST
Mailing Address - Street 2:
Mailing Address - City:HEWITT
Mailing Address - State:TX
Mailing Address - Zip Code:76643-3425
Mailing Address - Country:US
Mailing Address - Phone:254-548-8433
Mailing Address - Fax:
Practice Address - Street 1:423 S MAIN ST
Practice Address - Street 2:
Practice Address - City:MC GREGOR
Practice Address - State:TX
Practice Address - Zip Code:76657-1610
Practice Address - Country:US
Practice Address - Phone:254-840-2888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-03
Last Update Date:2018-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX112790235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX14279183OtherASHA