Provider Demographics
NPI:1821331224
Name:DENT, KEVIN DANIEL (MS, CCC-SLP)
Entity Type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:DANIEL
Last Name:DENT
Suffix:
Gender:M
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1365 LEXINGTON WAY
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36695-5034
Mailing Address - Country:US
Mailing Address - Phone:251-753-0427
Mailing Address - Fax:
Practice Address - Street 1:1365 LEXINGTON WAY
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36695-5034
Practice Address - Country:US
Practice Address - Phone:251-753-0427
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-03
Last Update Date:2013-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL3069235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist