Provider Demographics
NPI:1093047433
Name:GURTLER, KENDRA SUE (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:KENDRA
Middle Name:SUE
Last Name:GURTLER
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 1:1931 BULL ST
Mailing Address - Street 2:SUITE D
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29201-2560
Mailing Address - Country:US
Mailing Address - Phone:803-767-4832
Mailing Address - Fax:
Practice Address - Street 1:1931 BULL ST
Practice Address - Street 2:SUITE D
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29201-2560
Practice Address - Country:US
Practice Address - Phone:803-767-4832
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-10
Last Update Date:2010-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4557235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist