Provider Demographics
NPI:1003282831
Name:KENTER, KELSEY MAYRHOFER (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:KELSEY
Middle Name:MAYRHOFER
Last Name:KENTER
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7055 DUTCHLAND PKWY
Mailing Address - Street 2:
Mailing Address - City:LIBERTY TOWNSHIP
Mailing Address - State:OH
Mailing Address - Zip Code:45044-9042
Mailing Address - Country:US
Mailing Address - Phone:513-777-4420
Mailing Address - Fax:513-777-7950
Practice Address - Street 1:7055 DUTCHLAND PKWY
Practice Address - Street 2:
Practice Address - City:LIBERTY TOWNSHIP
Practice Address - State:OH
Practice Address - Zip Code:45044-9042
Practice Address - Country:US
Practice Address - Phone:513-777-4420
Practice Address - Fax:513-777-7950
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-17
Last Update Date:2017-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOND. 2015296235Z00000X
OHSP.12241235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist