MEDICARE: SANDRA KENT

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	2355S0801X	Speech-Language Assistant

General Provider Information

NPI Number	:	1730388869
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SANDRA KENT

Provider Business Mailing Address
First Line	:	PO BOX 274
Second Line	:
City	:	TWIN MOUNTAIN
State	:	NH
Zip	:	03595-0274
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	GENERAL DELIVERY
Second Line	:
City	:	TWIN MOUNTAIN
State	:	NH
Zip	:	03595-9999
Country	:	US
Telephone Number	:	603-356-6921
Fax Number	:

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

Provider Enumeration Date	:	07/18/2007
Last Update Date	:	07/18/2007

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Directions to “ SANDRA KENT ” Practice Location

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