| Doctor Name: | NANETTE S KENNELLY |
| NPI Number: | 1316160914 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MS CCC-SLP |
| License Number: | 664 |
| Business Practice Address: | 1220 Main Ave Suite 100 Fargo, ND - 581038201 |
| Business Phone Number: | 7013645433 |
| Business Fax Number: | 7013642256 |
| Mailing Address: | Po Box 746, FARGO |
| State: | ND |
| Postal Code: | 581070746 |
| Phone Number: | 7013645433 |
| Fax Number: | 7013642256 |
| NPI Enumeration Date: | 04/11/2007 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 664 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ND |
| 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 |