Provider Demographics
NPI:1982201471
Name:WRIGHT, KENDRA (LMT)
Entity Type:Individual
Prefix:
First Name:KENDRA
Middle Name:
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 W 99TH TER APT 206
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64114-4330
Mailing Address - Country:US
Mailing Address - Phone:816-820-4576
Mailing Address - Fax:
Practice Address - Street 1:115 W 99TH TER APT 206
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64114-4330
Practice Address - Country:US
Practice Address - Phone:816-820-4576
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-07
Last Update Date:2020-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2005017939225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist