Provider Demographics
NPI:1336284918
Name:LAHR, KENNETH EDWARD (MS,CCCLSP)
Entity Type:Individual
Prefix:
First Name:KENNETH
Middle Name:EDWARD
Last Name:LAHR
Suffix:
Gender:M
Credentials:MS,CCCLSP
Other - Prefix:
Other - First Name:KENNETH
Other - Middle Name:E
Other - Last Name:LAHR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS, CCCLSP
Mailing Address - Street 1:3736 BRIGHTWAY ST
Mailing Address - Street 2:
Mailing Address - City:WEIRTON
Mailing Address - State:WV
Mailing Address - Zip Code:26062-4437
Mailing Address - Country:US
Mailing Address - Phone:304-670-7213
Mailing Address - Fax:
Practice Address - Street 1:16351 STATE ROUTE 267
Practice Address - Street 2:
Practice Address - City:EAST LIVERPOOL
Practice Address - State:OH
Practice Address - Zip Code:43920-3931
Practice Address - Country:US
Practice Address - Phone:330-386-5093
Practice Address - Fax:330-386-0571
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP4620235Z00000X
WVSLP0345235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000364229OtherANTHEM