Provider Demographics
NPI:1144796418
Name:DELORENZO, KENDALL (AUD, CCC-A)
Entity Type:Individual
Prefix:DR
First Name:KENDALL
Middle Name:
Last Name:DELORENZO
Suffix:
Gender:F
Credentials:AUD, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19450 DEERFIELD AVE STE 400
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20176-6822
Mailing Address - Country:US
Mailing Address - Phone:703-687-6001
Mailing Address - Fax:
Practice Address - Street 1:19450 DEERFIELD AVE STE 400
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20176-6822
Practice Address - Country:US
Practice Address - Phone:703-687-6001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-15
Last Update Date:2019-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2201001699231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist