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General NPI Number Information
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NPI Number | 1194540161
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Entity Type | Individual
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Provider Name | KENDALL RICE MS CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 11/15/2024
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Last Update Date | 12/31/2024
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Provider Practice Location Address
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Address Line | 20 MEDICAL CAMPUS DR NW STE 204
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City | SUPPLY
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State | NC
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Zip | 28462-4094
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Country | US
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Telephone | 910-612-1002
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Fax |
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Provider Business Mailing Address
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Address Line | 473 WOODBURY CT SE
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City | BOLIVIA
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State | NC
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Zip | 28422-8685
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Country | US
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Telephone | 910-612-1002
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Fax | 910-755-5865
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 30002605
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License Number State | NC
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