Healthcare Provider Details

I. General information

NPI: 1902890551
Provider Name (Legal Business Name): EFFIE KENDALL OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/08/2005
Last Update Date: 07/13/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UNIT 5210 BOX 230
APO AE
09661
GB

IV. Provider business mailing address

PSC 41 BOX 6378
APO AE
09464
GB

V. Phone/Fax

Practice location:
  • Phone: 441638523308
  • Fax: 441638526600
Mailing address:
  • Phone: 441638523308
  • Fax: 441638526600

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberOT-00335
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: