Provider Demographics
NPI:1316050339
Name:KAMENDAT, ABBEY LYNN
Entity type:Individual
Prefix:MRS
First Name:ABBEY
Middle Name:LYNN
Last Name:KAMENDAT
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:ABBEY
Other - Middle Name:LYNN
Other - Last Name:HERR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3847 PINE GROVE AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:FORT GRATIOT
Mailing Address - State:MI
Mailing Address - Zip Code:48059-4265
Mailing Address - Country:US
Mailing Address - Phone:810-966-3720
Mailing Address - Fax:810-984-8111
Practice Address - Street 1:3847 PINE GROVE AVE
Practice Address - Street 2:SUITE A
Practice Address - City:FORT GRATIOT
Practice Address - State:MI
Practice Address - Zip Code:48059-4265
Practice Address - Country:US
Practice Address - Phone:810-966-3720
Practice Address - Fax:810-984-8111
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker