Provider Demographics
NPI:1669648598
Name:KRISTINE L KENNEY-MICHAUD
Entity Type:Organization
Organization Name:KRISTINE L KENNEY-MICHAUD
Other - Org Name:SPEECH & LANGUAGE THERAPY SERVICES FOR CHILDREN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KRISTINE
Authorized Official - Middle Name:L
Authorized Official - Last Name:KENNEY-MICHAUD
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:508-677-9797
Mailing Address - Street 1:87 BAYVIEW ST
Mailing Address - Street 2:
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02724-1819
Mailing Address - Country:US
Mailing Address - Phone:508-677-9797
Mailing Address - Fax:508-677-9922
Practice Address - Street 1:1610 GRAND ARMY HWY
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:MA
Practice Address - Zip Code:02726-1210
Practice Address - Country:US
Practice Address - Phone:508-677-9797
Practice Address - Fax:508-677-9922
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-30
Last Update Date:2012-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA5036235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty