Provider Demographics
NPI:1851672562
Name:TINDEL, KENNETH WAYNE (ATP)
Entity Type:Individual
Prefix:MR
First Name:KENNETH
Middle Name:WAYNE
Last Name:TINDEL
Suffix:
Gender:M
Credentials:ATP
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Mailing Address - Street 1:1901 S PALESTINE ST
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:TX
Mailing Address - Zip Code:75751-5701
Mailing Address - Country:US
Mailing Address - Phone:903-675-9360
Mailing Address - Fax:903-675-1570
Practice Address - Street 1:1901 S PALESTINE ST
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:TX
Practice Address - Zip Code:75751-5701
Practice Address - Country:US
Practice Address - Phone:903-675-9360
Practice Address - Fax:903-675-1570
Is Sole Proprietor?:No
Enumeration Date:2011-09-08
Last Update Date:2011-09-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXATP 44058225CA2400X, 225CA2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225CA2400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation CounselorAssistive Technology Practitioner
No225CA2500XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation CounselorAssistive Technology Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXATP 44058OtherASSISTIVE TECHNOLOGY PROFESSIONAL