Doctor Name: | MS. CAROLYN LOUISE KENNGOTT |
NPI Number: | 1518010677 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.A.,CCC,SLP |
License Number: | 656 |
Business Practice Address: | 519 Bourne Ln Victor, MT - 598759775 |
Business Phone Number: | 4069613592 |
Business Fax Number: | |
Mailing Address: | 519 Bourne Ln, VICTOR |
State: | MT |
Postal Code: | 598759775 |
Phone Number: | 4069613592 |
Fax Number: | |
NPI Enumeration Date: | 01/19/2007 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 656 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MT |
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 |