Provider Demographics
NPI:1033489786
Name:LEHNERT, KATHLEEN MORRISON (MS)
Entity Type:Individual
Prefix:MRS
First Name:KATHLEEN
Middle Name:MORRISON
Last Name:LEHNERT
Suffix:
Gender:F
Credentials:MS
Other - Prefix:MISS
Other - First Name:KATHLEEN
Other - Middle Name:ANNE
Other - Last Name:MORRISON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:PO BOX 64588
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21264-4588
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:601 N CAROLINE ST
Practice Address - Street 2:SUITE 6018
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21287-0006
Practice Address - Country:US
Practice Address - Phone:410-955-9397
Practice Address - Fax:410-614-9167
Is Sole Proprietor?:No
Enumeration Date:2012-01-11
Last Update Date:2013-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD06792235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD332277700Medicaid
MD332277700Medicaid