Provider Demographics
NPI:1174170500
Name:KEMPE, MARY (HIS)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:
Last Name:KEMPE
Suffix:
Gender:F
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2221 EQUESTRIAN DR APT 1A
Mailing Address - Street 2:
Mailing Address - City:MIAMISBURG
Mailing Address - State:OH
Mailing Address - Zip Code:45342-5661
Mailing Address - Country:US
Mailing Address - Phone:330-464-7790
Mailing Address - Fax:
Practice Address - Street 1:1370 N FAIRFIELD RD STE F
Practice Address - Street 2:
Practice Address - City:BEAVERCREEK
Practice Address - State:OH
Practice Address - Zip Code:45432-2681
Practice Address - Country:US
Practice Address - Phone:937-320-1111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-21
Last Update Date:2019-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHIL.03412237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist