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General NPI Number Information
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NPI Number | 1366717241
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Entity Type | Individual
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Provider Name | ESSA KENNEDY CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 03/12/2012
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Last Update Date | 03/12/2012
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Provider Practice Location Address
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Address Line | 447 NW 73RD AVE
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City | PLANTATION
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State | FL
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Zip | 33317-1608
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Country | US
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Telephone | 954-873-7383
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Fax |
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Provider Business Mailing Address
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Address Line | 9150 NW 26TH ST
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City | SUNRISE
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State | FL
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Zip | 33322-2821
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Country | US
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Telephone | 954-873-4609
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Fax |
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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 | SA7493
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License Number State | FL
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