Provider Demographics
NPI:1063741338
Name:KER, KENDY J (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:KENDY
Middle Name:J
Last Name:KER
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4606 SPRING ST
Mailing Address - Street 2:
Mailing Address - City:WALL TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:07753-6932
Mailing Address - Country:US
Mailing Address - Phone:732-280-3068
Mailing Address - Fax:
Practice Address - Street 1:4606 SPRING ST
Practice Address - Street 2:
Practice Address - City:WALL TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:07753-6932
Practice Address - Country:US
Practice Address - Phone:732-280-3068
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-16
Last Update Date:2009-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00456400235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist