Provider Demographics
NPI:1164086922
Name:NEUNDORFER, KALI (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:KALI
Middle Name:
Last Name:NEUNDORFER
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18689 E SHORELAND AVE
Mailing Address - Street 2:
Mailing Address - City:ROCKY RIVER
Mailing Address - State:OH
Mailing Address - Zip Code:44116-2812
Mailing Address - Country:US
Mailing Address - Phone:440-376-1050
Mailing Address - Fax:
Practice Address - Street 1:30325 BAINBRIDGE RD.
Practice Address - Street 2:SUITE A-5
Practice Address - City:SOLON
Practice Address - State:OH
Practice Address - Zip Code:44139-2271
Practice Address - Country:US
Practice Address - Phone:440-376-1050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-26
Last Update Date:2019-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH12824235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist