Provider Demographics
NPI:1295388460
Name:BAHRI, KENDYL P (T-LMLP)
Entity Type:Individual
Prefix:
First Name:KENDYL
Middle Name:P
Last Name:BAHRI
Suffix:
Gender:F
Credentials:T-LMLP
Other - Prefix:
Other - First Name:KENDYL
Other - Middle Name:P
Other - Last Name:DENNISON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:T-LMLP
Mailing Address - Street 1:1901 E 1ST ST; PO BOX 467
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:KS
Mailing Address - Zip Code:67114-0467
Mailing Address - Country:US
Mailing Address - Phone:316-284-6400
Mailing Address - Fax:316-284-6490
Practice Address - Street 1:1901 E 1ST ST
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:KS
Practice Address - Zip Code:67114-5010
Practice Address - Country:US
Practice Address - Phone:316-284-6400
Practice Address - Fax:316-284-6490
Is Sole Proprietor?:No
Enumeration Date:2019-07-17
Last Update Date:2020-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2926103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical