Provider Demographics
NPI:1639974181
Name:CARAWAY, KENDRA MICHELLE-ANNE
Entity type:Individual
Prefix:
First Name:KENDRA
Middle Name:MICHELLE-ANNE
Last Name:CARAWAY
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8620 SPRING CYPRESS RD STE D
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77379-3319
Mailing Address - Country:US
Mailing Address - Phone:775-846-1220
Mailing Address - Fax:
Practice Address - Street 1:8620 SPRING CYPRESS RD STE D
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77379-3319
Practice Address - Country:US
Practice Address - Phone:775-846-1220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-18
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician