MEDICARE: KENDRA D BARNUM M.S., CCC-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
1	235Z00000X	Speech-Language Pathologist	3380	OK

General Provider Information

NPI Number	:	1336849033
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KENDRA D BARNUM M.S., CCC-SLP

Provider Business Mailing Address
First Line	:	8325 N ASHLEY DR
Second Line	:
City	:	EDMOND
State	:	OK
Zip	:	73025-1557
Country	:	US
Telephone Number	:	405-388-4130
Fax Number	:

Provider Business Practice Location Address
First Line	:	5800 GRANITE PKWY STE 1000
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75024-6619
Country	:	US
Telephone Number	:	405-317-2610
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/09/2023
Last Update Date	:	03/09/2023

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Directions to “ KENDRA D BARNUM M.S., CCC-SLP” Practice Location

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