Individual ProviderLarae KelleySpeech-Language PathologistSpeech, Language and Hearing Service ProvidersPractice Address4208 Retama Cir, Victoria, TX 77901-2765(361) 578-2257PECOS EnrollmentBased on the most recent information from CMS, provider Larae Kelley does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1790161461Provider TypeIndividualFull NameKelley, LaraeCredentialMS-SLP-CCCGenderFemaleSole ProprietorYesEnumeration Date8/5/2015Last Updated7/3/2025Contact InformationPractice LocationPractice Address4208 Retama Cir, Victoria, TX 77901-2765Phone(361) 578-2257Fax(361) 578-2260Mailing LocationMailing Address4208 Retama Cir, Victoria, TX 77901-2765Phone(361) 578-2257Fax(361) 578-2260Provider TaxonomiesCodeDescriptionLicenseCode235Z00000XPrimaryDescriptionSpeech-Language PathologistSpeech, Language and Hearing Service ProvidersLicense111556Texas