=====================================================
General NPI Number Information
=====================================================
NPI Number | 1871425090
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KENNEDY JEAN VOTAVA
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/01/2026
-----------------------------------------------------
Last Update Date | 06/01/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 131 W HOWELL ST
-----------------------------------------------------
City | HARTWELL
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30643-1888
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 706-981-9314
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 33 SUMMER HILL DR
-----------------------------------------------------
City | HOSCHTON
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30548-3093
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 235Z00000X
-----------------------------------------------------
Taxonomy Name | Speech-Language Pathologist
-----------------------------------------------------
License Number | PCET004473
-----------------------------------------------------
License Number State | GA
-----------------------------------------------------