MEDICARE: KAREN SLOULIN KENDALL PHD

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	103TC0700X	Clinical Psychologist	543	OK

General Provider Information

NPI Number	:	1710920350
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAREN SLOULIN KENDALL PHD

Provider Business Mailing Address
First Line	:	PO BOX 13766
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73113-1766
Country	:	US
Telephone Number	:	405-602-6466
Fax Number	:	405-525-8477

Provider Business Practice Location Address
First Line	:	3106 NORCREST DR
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73121-1844
Country	:	US
Telephone Number	:	405-602-6466
Fax Number	:	405-525-8477

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

Provider Enumeration Date	:	06/13/2006
Last Update Date	:	04/02/2008

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