Provider Demographics
NPI:1194359273
Name:HENNING, KARA S (CCC/SLP)
Entity Type:Individual
Prefix:
First Name:KARA
Middle Name:S
Last Name:HENNING
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 1:1020 NEW HOLLAND AVE
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-5606
Mailing Address - Country:US
Mailing Address - Phone:717-606-1398
Mailing Address - Fax:717-606-1995
Practice Address - Street 1:1020 NEW HOLLAND AVE
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-5606
Practice Address - Country:US
Practice Address - Phone:717-606-1398
Practice Address - Fax:717-606-1995
Is Sole Proprietor?:No
Enumeration Date:2020-02-27
Last Update Date:2020-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL003146L235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PASL003146LOtherBUREAU OF PROFESSIONAL AND OCCUPATIONAL AFFAIRS