Provider Demographics
NPI:1508075417
Name:PENDLETON, LA SAUNDRA (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:LA SAUNDRA
Middle Name:
Last Name:PENDLETON
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1029 LEE ST
Mailing Address - Street 2:APT. 1
Mailing Address - City:COVINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:41011-2208
Mailing Address - Country:US
Mailing Address - Phone:859-308-0523
Mailing Address - Fax:
Practice Address - Street 1:1029 LEE ST
Practice Address - Street 2:APT. 1
Practice Address - City:COVINGTON
Practice Address - State:KY
Practice Address - Zip Code:41011-2208
Practice Address - Country:US
Practice Address - Phone:859-308-0523
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2016-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3232235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist