Provider Demographics
NPI:1306061460
Name:BROWN, KENDRA (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:KENDRA
Middle Name:
Last Name:BROWN
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 1:16012 W 147TH TER
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66062-4706
Mailing Address - Country:US
Mailing Address - Phone:602-434-5157
Mailing Address - Fax:
Practice Address - Street 1:16012 W 147TH TER
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66062-4706
Practice Address - Country:US
Practice Address - Phone:602-434-5157
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-16
Last Update Date:2016-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4864235Z00000X
KS3676235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist