MEDICARE: KENDALL ELIESE MYERS 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
1	235Z00000X	Speech-Language Pathologist	30005247	NC

General Provider Information

NPI Number	:	1598602831
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KENDALL ELIESE MYERS CCC-SLP

Provider Business Mailing Address
First Line	:	1920 NC-54 STE 240, 360
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27113
Country	:	US
Telephone Number	:	919-378-1340
Fax Number	:

Provider Business Practice Location Address
First Line	:	1920 NC-54 STE 240, 360
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27713
Country	:	US
Telephone Number	:	919-378-1340
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/04/2026
Last Update Date	:	06/09/2026

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Directions to “ KENDALL ELIESE MYERS CCC-SLP” Practice Location

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