Provider Demographics
NPI:1578762613
Name:KIRKENDALL, EMILY DREW (AUD)
Entity Type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:DREW
Last Name:KIRKENDALL
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:LYNN
Other - Last Name:DREW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:510 E. NORTH BROADWAY
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43214
Mailing Address - Country:US
Mailing Address - Phone:614-261-5449
Mailing Address - Fax:614-261-5440
Practice Address - Street 1:510 E. NORTH BROADWAY
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214
Practice Address - Country:US
Practice Address - Phone:614-261-5449
Practice Address - Fax:614-261-5440
Is Sole Proprietor?:No
Enumeration Date:2007-07-17
Last Update Date:2014-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHA01618231H00000X
231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist