Provider Demographics
NPI:1093251456
Name:FARNHAM, KENDRA MAE
Entity Type:Individual
Prefix:
First Name:KENDRA
Middle Name:MAE
Last Name:FARNHAM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KENDRA
Other - Middle Name:M
Other - Last Name:TRAHAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7695 ANDERSON OAKS DR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45255-3075
Mailing Address - Country:US
Mailing Address - Phone:859-333-5330
Mailing Address - Fax:
Practice Address - Street 1:7695 ANDERSON OAKS DR
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45255-3075
Practice Address - Country:US
Practice Address - Phone:859-333-5330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-10
Last Update Date:2021-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN4262225X00000X
OHOT011259225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist