Provider Demographics
NPI:1740793611
Name:BRATT, KENDRA ROSE (MA CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:KENDRA
Middle Name:ROSE
Last Name:BRATT
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:670 FLAGSTAFF LN
Mailing Address - Street 2:
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60169-3004
Mailing Address - Country:US
Mailing Address - Phone:630-204-3142
Mailing Address - Fax:
Practice Address - Street 1:421 N LAKE ST
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60506-4180
Practice Address - Country:US
Practice Address - Phone:630-844-0380
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-14
Last Update Date:2017-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146.013531235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist