Provider Demographics
NPI:1629717616
Name:MORALES, KENDALL VICTORIA (AUD)
Entity Type:Individual
Prefix:
First Name:KENDALL
Middle Name:VICTORIA
Last Name:MORALES
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:KENDALL
Other - Middle Name:VICTORIA
Other - Last Name:OGLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3601 4TH ST MS 9905
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79430-0002
Mailing Address - Country:US
Mailing Address - Phone:806-743-3277
Mailing Address - Fax:
Practice Address - Street 1:3601 4TH ST MS 9905
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79430-0002
Practice Address - Country:US
Practice Address - Phone:806-743-3277
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-31
Last Update Date:2022-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX81362231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist