Provider Demographics
NPI:1396120572
Name:SEXE, KENDALL MARIE (MS)
Entity type:Individual
Prefix:MRS
First Name:KENDALL
Middle Name:MARIE
Last Name:SEXE
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 QUINLAN AVE N
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:MN
Mailing Address - Zip Code:55043-9494
Mailing Address - Country:US
Mailing Address - Phone:651-245-2676
Mailing Address - Fax:
Practice Address - Street 1:420 DELEWARE STREET SE
Practice Address - Street 2:MMC 106/MAYO B-414 UNIVERSITY OF MINNESOTA HEALTH,
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55414
Practice Address - Country:US
Practice Address - Phone:612-273-5961
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-29
Last Update Date:2015-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN9528235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist