Provider Demographics
NPI:1346529393
Name:HANTELMAN, KENDALL SHAWN
Entity Type:Individual
Prefix:MRS
First Name:KENDALL
Middle Name:SHAWN
Last Name:HANTELMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:KENDALL
Other - Middle Name:SHAWN
Other - Last Name:GROVE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:507 CRESTVIEW CT
Mailing Address - Street 2:
Mailing Address - City:JEFFERSONVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47130-4409
Mailing Address - Country:US
Mailing Address - Phone:317-379-3265
Mailing Address - Fax:
Practice Address - Street 1:1100 E MARKET ST
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40206-1838
Practice Address - Country:US
Practice Address - Phone:502-596-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-09
Last Update Date:2011-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst