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NPI Code Detail

MEDICARE: KATHRYN LAINE HENDERSON M.S., CCC-SLP

MEDICARE: KATHRYN LAINE HENDERSON 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
1235Z00000XSpeech-Language Pathologist6041AL

General Provider Information

NPI Number : 1356280671
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHRYN LAINE HENDERSON M.S., CCC-SLP
Provider Business Mailing Address
First Line : 1700 5TH AVE S
Second Line :
City : JASPER
State : AL
Zip : 35501-5334
Country : US
Telephone Number : 205-388-0563
Fax Number : 205-512-2548
Provider Business Practice Location Address
First Line : 1700 5TH AVE S
Second Line :
City : JASPER
State : AL
Zip : 35501-5334
Country : US
Telephone Number : 205-388-0563
Fax Number : 205-512-2548
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/25/2026
Last Update Date : 03/25/2026

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Directions to “ KATHRYN LAINE HENDERSON M.S., CCC-SLP” Practice Location

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