Provider Demographics
NPI:1508877721
Name:EARWOOD, KENDRA LEIGH (MS CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:KENDRA
Middle Name:LEIGH
Last Name:EARWOOD
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:10 POWDER MILL ROAD
Mailing Address - Street 2:
Mailing Address - City:EXETER
Mailing Address - State:NH
Mailing Address - Zip Code:03833-4318
Mailing Address - Country:US
Mailing Address - Phone:910-690-4033
Mailing Address - Fax:866-210-5259
Practice Address - Street 1:989 OCEAN BLVD
Practice Address - Street 2:UNIT 10
Practice Address - City:HAMPTON
Practice Address - State:NH
Practice Address - Zip Code:03842-1453
Practice Address - Country:US
Practice Address - Phone:603-601-2752
Practice Address - Fax:866-210-5259
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2012-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5298235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7411680Medicaid
NC1317KOtherBCBS
NH30407908Medicaid