Provider Demographics
NPI:1720234867
Name:HENDEE, MARY KAY (SLP)
Entity type:Individual
Prefix:MRS
First Name:MARY
Middle Name:KAY
Last Name:HENDEE
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:MRS
Other - First Name:MARY
Other - Middle Name:KATHERINE
Other - Last Name:HENDEE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:SLP
Mailing Address - Street 1:41 OCONNOR RD
Mailing Address - Street 2:
Mailing Address - City:FAIRPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14450-1327
Mailing Address - Country:US
Mailing Address - Phone:585-377-4660
Mailing Address - Fax:
Practice Address - Street 1:41 OCONNOR RD
Practice Address - Street 2:
Practice Address - City:FAIRPORT
Practice Address - State:NY
Practice Address - Zip Code:14450-1327
Practice Address - Country:US
Practice Address - Phone:585-377-4660
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-08
Last Update Date:2011-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009713-1235Z00000X
235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist