Provider Demographics
NPI:1902006968
Name:WALTHER, KENDRA DEON
Entity Type:Individual
Prefix:MS
First Name:KENDRA
Middle Name:DEON
Last Name:WALTHER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KENDRA
Other - Middle Name:DEAON
Other - Last Name:ROGERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SLP
Mailing Address - Street 1:2252 N 44TH ST
Mailing Address - Street 2:#1063
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85008-3200
Mailing Address - Country:US
Mailing Address - Phone:785-493-4825
Mailing Address - Fax:
Practice Address - Street 1:14130 W CAVIT ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67235-9154
Practice Address - Country:US
Practice Address - Phone:316-303-7769
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-18
Last Update Date:2021-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist