Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Kelly Jo Premo, MSCCCSLP

Individual provider Speech-Language Pathologist · NPI 1891117990

Kelly Jo Premo, MSCCCSLP is a Speech-Language Pathologist in Ballston Lake, New York. Practices as a sole proprietor. Licensed in New York.

Licensed in
NY
In the registry since
2014
Specialties on file
2

Practice location Address checks out

118 Westside Dr
Ballston Lake, NY 12019-2028
Phone: (518) 424-7971
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Early Intervention Provider Agency (primary) Taxonomy 252Y00000X · Licence 022776-1 (NY)
Speech-Language Pathologist Taxonomy 235Z00000X · Licence 022776-1 (NY)

Record details

NPI number1891117990
Entity typeIndividual (Type 1)
GenderFemale
Credentials MSCCCSLP
Sole proprietorYes
NPI enumeratedJanuary 9, 2014
Last updated in NPPESApril 14, 2020
Certification dateApril 14, 2020

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