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NPI Code Detail

MEDICARE: HEATHER MARIE KENNEHAN M.A., CFY-SLP

MEDICARE: HEATHER MARIE KENNEHAN M.A., CFY-SLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist2015042OH

General Provider Information

NPI Number : 1154725257
Entity Type Code : Individual
Provider Name (Legal Business Name) : HEATHER MARIE KENNEHAN M.A., CFY-SLP
Provider Business Mailing Address
First Line : 10603 DETROIT AVE
Second Line :
City : CLEVELAND
State : OH
Zip : 44102-1647
Country : US
Telephone Number : 216-226-0282
Fax Number :
Provider Business Practice Location Address
First Line : 10603 DETROIT AVE
Second Line :
City : CLEVELAND
State : OH
Zip : 44102-1647
Country : US
Telephone Number : 216-226-0282
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/17/2014
Last Update Date : 10/17/2014

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Directions to “ HEATHER MARIE KENNEHAN M.A., CFY-SLP” Practice Location

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