Healthcare Provider Details

I. General information

NPI: 1124528542
Provider Name (Legal Business Name): MONICA KENNEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/13/2018
Last Update Date: 05/28/2024
Certification Date: 05/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 N MEADOWS RD
MEDFIELD MA
02052-2317
US

IV. Provider business mailing address

3 SURREY DR
LAKEVILLE MA
02347-1355
US

V. Phone/Fax

Practice location:
  • Phone: 508-359-4532
  • Fax:
Mailing address:
  • Phone: 508-951-8277
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: