Provider Demographics
NPI:1821241266
Name:KENNEDY, LUCINDA M (MSED;CCC/SLP;NYS LIC)
Entity Type:Individual
Prefix:MS
First Name:LUCINDA
Middle Name:M
Last Name:KENNEDY
Suffix:
Gender:F
Credentials:MSED;CCC/SLP;NYS LIC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4321 NIAGARA RAPIDS BLVD
Mailing Address - Street 2:
Mailing Address - City:NIAGARA FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:14305
Mailing Address - Country:US
Mailing Address - Phone:716-285-0769
Mailing Address - Fax:
Practice Address - Street 1:1100 RANSOM RD
Practice Address - Street 2:
Practice Address - City:GRAND ISLAND
Practice Address - State:NY
Practice Address - Zip Code:14072-1460
Practice Address - Country:US
Practice Address - Phone:716-773-8800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-29
Last Update Date:2011-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006967-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist