Mrs Mary Kathleen Kennedy, EDDSPED,CCC-SLP is a
Speech-language Pathologist based in Hideaway, Texas. Mrs Mary Kathleen Kennedy is licensed to practice in Texas (license number 11254) and her current practice location is
1613 Ginger Dr, Hideaway, Texas. She can be reached at her office (for appointments etc.) via phone at
(903) 530-8169.
NPI number for Mrs Mary Kathleen Kennedy is 1053455568 and her current mailing address is 1613 Ginger Dr, Hideaway, Texas. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1053455568.
Healthcare Provider's Profile
| Full Name | Mrs Mary Kathleen Kennedy |
|---|
| Gender | Female |
|---|
| Speciality | Speech-language Pathologist |
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| Location | 1613 Ginger Dr, Hideaway, Texas |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1053455568
- Provider Enumeration Date: 02/16/2007
- Last Update Date: 07/08/2007
Medical Identifiers
Medical identifiers for Mrs Mary Kathleen Kennedy such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1053455568 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 235Z00000X | Speech-language Pathologist | 11254 (Texas) | Primary |
| 235Z00000X | Speech-language Pathologist | SA8471 (Florida) | Secondary |
| 235Z00000X | Speech-language Pathologist | 6816 (Massachusetts) | Secondary |
| 235Z00000X | Speech-language Pathologist | 3892 (New Mexico) | Secondary |
| 235Z00000X | Speech-language Pathologist | SP1522 (Maine) | Secondary |
| 235Z00000X | Speech-language Pathologist | SP15930 (California) | Secondary |
| 235Z00000X | Speech-language Pathologist | (Illinois) | Secondary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mrs Mary Kathleen Kennedy is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Mrs Mary Kathleen Kennedy, EDDSPED,CCC-SLP
1613 Ginger Dr,
Hideaway, TX 75771-5311
Ph: (903) 530-8169 | Mrs Mary Kathleen Kennedy, EDDSPED,CCC-SLP
1613 Ginger Dr,
Hideaway, TX 75771-5311
Ph: (903) 530-8169 |
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