Provider Demographics
NPI:1821468091
Name:WATSON, KENDRA KILPATRICK (MA CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:KENDRA
Middle Name:KILPATRICK
Last Name:WATSON
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 1:338 1ST AVE SW
Mailing Address - Street 2:
Mailing Address - City:TAYLORSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28681-2402
Mailing Address - Country:US
Mailing Address - Phone:828-632-9704
Mailing Address - Fax:828-632-9008
Practice Address - Street 1:338 1ST AVE SW
Practice Address - Street 2:
Practice Address - City:TAYLORSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28681-2402
Practice Address - Country:US
Practice Address - Phone:828-632-9704
Practice Address - Fax:828-632-9008
Is Sole Proprietor?:No
Enumeration Date:2015-09-30
Last Update Date:2015-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3863235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist