Kennedy Bannon, CF-SLP
Individual provider Active NPI Speech-Language Pathologist · Maricopa, AZ
NPI 1659040897 · NPPES record last updated Sep 10, 2021
Key facts
- NPI
- 1659040897
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- TSLP13344 (AZ)
- Practice address
- 18150 N Alterra Pkwy
Maricopa, AZ 85139-4200 - Phone
- (520) 568-5160
- NPI assigned
- Sep 10, 2021
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| TSLP13344 | AZ | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | TSLP13344 | AZ | Yes |
Addresses
Primary practice location
18150 N Alterra Pkwy
Maricopa, AZ 85139-4200
Mailing address
18150 N Alterra Pkwy
Maricopa, AZ 85139-4200
Other providers in Maricopa, AZ
- Marla Baker
- Thomas Balaskas
- Sherisa Mae Banks
- Banner - University Physician Specialists LLC
- Banner Primary Care Physicians Arizona LLC
- Polina Barboy
- Anita Carol Bargen
- Josephine Marie Barrand
- Cody Barta
- Verna Barya
All providers in Maricopa, AZ · Speech-Language Pathologist in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 10, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.