Doctor Name: | ALLISON KENNELLY |
NPI Number: | 1073826566 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | SLP |
License Number: | SLP6813 |
Business Practice Address: | 25615 N Ranch Gate Rd Scottsdale, AZ - 852552141 |
Business Phone Number: | 6232033129 |
Business Fax Number: | |
Mailing Address: | 10706 W Jefferson St, AVONDALE |
State: | AZ |
Postal Code: | 853233342 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 07/26/2010 |
NPI Last Update Date: | 11/03/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SLP6813 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AZ |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |