Provider Demographics
NPI:1194017582
Name:DIGWOOD, KINDRA (MA CCC SLP)
Entity Type:Individual
Prefix:MISS
First Name:KINDRA
Middle Name:
Last Name:DIGWOOD
Suffix:
Gender:F
Credentials:MA CCC SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 LYNWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:SCRANTON
Mailing Address - State:PA
Mailing Address - Zip Code:18505-2868
Mailing Address - Country:US
Mailing Address - Phone:570-346-7381
Mailing Address - Fax:
Practice Address - Street 1:100 LYNWOOD AVE
Practice Address - Street 2:
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18505-2868
Practice Address - Country:US
Practice Address - Phone:570-346-7381
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-04
Last Update Date:2011-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA14042181235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist