Provider Demographics
NPI:1740272780
Name:DOYLE, KENDA M (SLP)
Entity type:Individual
Prefix:
First Name:KENDA
Middle Name:M
Last Name:DOYLE
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5047 DUNSHA RD
Mailing Address - Street 2:
Mailing Address - City:MEDINA
Mailing Address - State:OH
Mailing Address - Zip Code:44256-8483
Mailing Address - Country:US
Mailing Address - Phone:330-239-4491
Mailing Address - Fax:330-239-4490
Practice Address - Street 1:5047 DUNSHA RD
Practice Address - Street 2:
Practice Address - City:MEDINA
Practice Address - State:OH
Practice Address - Zip Code:44256-8483
Practice Address - Country:US
Practice Address - Phone:330-239-4491
Practice Address - Fax:330-239-4490
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH6726235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist