Provider Demographics
NPI:1447598297
Name:KENDRICK, JENNIFER S (SLT)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:S
Last Name:KENDRICK
Suffix:
Gender:F
Credentials:SLT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:403 S LEE ST
Mailing Address - Street 2:
Mailing Address - City:LEESVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29070-7712
Mailing Address - Country:US
Mailing Address - Phone:803-532-1155
Mailing Address - Fax:803-532-8027
Practice Address - Street 1:403 S LEE ST
Practice Address - Street 2:
Practice Address - City:LEESVILLE
Practice Address - State:SC
Practice Address - Zip Code:29070-7712
Practice Address - Country:US
Practice Address - Phone:803-532-1155
Practice Address - Fax:803-532-8027
Is Sole Proprietor?:No
Enumeration Date:2013-01-29
Last Update Date:2013-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC179071235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist