Provider Demographics
NPI:1477179224
Name:HUSKEY, KENDALL
Entity type:Individual
Prefix:
First Name:KENDALL
Middle Name:
Last Name:HUSKEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KENDALL
Other - Middle Name:
Other - Last Name:GREEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3011 BOONE AVE N
Mailing Address - Street 2:
Mailing Address - City:NEW HOPE
Mailing Address - State:MN
Mailing Address - Zip Code:55427-2418
Mailing Address - Country:US
Mailing Address - Phone:480-468-3805
Mailing Address - Fax:
Practice Address - Street 1:3011 BOONE AVE N
Practice Address - Street 2:
Practice Address - City:NEW HOPE
Practice Address - State:MN
Practice Address - Zip Code:55427-2418
Practice Address - Country:US
Practice Address - Phone:480-468-3805
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-17
Last Update Date:2025-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN528501235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL23345OtherFLORIDA DEPARTMENT OF HEALTH
MN528501OtherMINNESOTA DEPARTMENT OF HEALTH
AZSLP12468OtherARIZONA DEPARTMENT OF HEALTH SERVICES