Provider Demographics
NPI:1386242568
Name:MULHERN, KENSLIE ELIZABETH (MS CCC-SLP, CBIS)
Entity type:Individual
Prefix:MRS
First Name:KENSLIE
Middle Name:ELIZABETH
Last Name:MULHERN
Suffix:
Gender:F
Credentials:MS CCC-SLP, CBIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 OLD FARM RD
Mailing Address - Street 2:
Mailing Address - City:TINTON FALLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07724-3271
Mailing Address - Country:US
Mailing Address - Phone:570-332-9092
Mailing Address - Fax:
Practice Address - Street 1:8 OLD FARM RD
Practice Address - Street 2:
Practice Address - City:TINTON FALLS
Practice Address - State:NJ
Practice Address - Zip Code:07724-3271
Practice Address - Country:US
Practice Address - Phone:570-332-9092
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-11
Last Update Date:2020-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00812200235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty