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NPI Code Detail

MEDICARE: HANNAH KENNEWEG MS, CCC-SLP

MEDICARE: HANNAH KENNEWEG MS, CCC-SLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist5382OK

General Provider Information

NPI Number : 1386198091
Entity Type Code : Individual
Provider Name (Legal Business Name) : HANNAH KENNEWEG MS, CCC-SLP
Provider Business Mailing Address
First Line : 2141 S FLORENCE AVE
Second Line :
City : TULSA
State : OK
Zip : 74114-1832
Country : US
Telephone Number : 918-269-8486
Fax Number :
Provider Business Practice Location Address
First Line : 6715 E 41ST ST
Second Line :
City : TULSA
State : OK
Zip : 74145-4520
Country : US
Telephone Number : 918-806-0106
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/10/2016
Last Update Date : 09/01/2021

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