Provider Demographics
NPI:1770796344
Name:KENDALL, LORINDA KAY (COTAL)
Entity type:Individual
Prefix:
First Name:LORINDA
Middle Name:KAY
Last Name:KENDALL
Suffix:
Gender:F
Credentials:COTAL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1538 S 9TH ST W
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59801-3437
Mailing Address - Country:US
Mailing Address - Phone:406-728-5663
Mailing Address - Fax:
Practice Address - Street 1:4718 23RD AVE
Practice Address - Street 2:SUITE 500
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59803-1163
Practice Address - Country:US
Practice Address - Phone:406-626-0400
Practice Address - Fax:406-626-0401
Is Sole Proprietor?:No
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT103224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant