MEDICARE: KATHRYN RUTH KENDALL M.A.

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	SP.9388	OH

General Provider Information

NPI Number	:	1417105826
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHRYN RUTH KENDALL M.A.

Provider Business Mailing Address
First Line	:	4265 REDMONT AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45236-3134
Country	:	US
Telephone Number	:	513-284-3013
Fax Number	:

Provider Business Practice Location Address
First Line	:	4515 TOWER AVE
Second Line	:
City	:	SAINT BERNARD
State	:	OH
Zip	:	45217-1723
Country	:	US
Telephone Number	:	513-482-7158
Fax Number	:

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

Provider Enumeration Date	:	08/28/2008
Last Update Date	:	10/09/2014

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