Provider Demographics
NPI:1093042046
Name:LEVY, KENDALL LANGDON (MA CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:KENDALL
Middle Name:LANGDON
Last Name:LEVY
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:MS
Other - First Name:LEE
Other - Middle Name:KENDALL
Other - Last Name:LANGDON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA CCC-SLP
Mailing Address - Street 1:2302 GRISWOLD LN
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78703-2960
Mailing Address - Country:US
Mailing Address - Phone:512-415-2536
Mailing Address - Fax:
Practice Address - Street 1:2302 GRISWOLD LN
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78703-2960
Practice Address - Country:US
Practice Address - Phone:512-415-2536
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-12
Last Update Date:2014-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX100338235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist