Provider Demographics
NPI:1174913255
Name:HALL, KENDAL BROOKE (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:KENDAL
Middle Name:BROOKE
Last Name:HALL
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:KENDAL
Other - Middle Name:BROOKE
Other - Last Name:ALLRED
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:244 CALHOUN ST APT C
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29401-1308
Mailing Address - Country:US
Mailing Address - Phone:843-566-1000
Mailing Address - Fax:
Practice Address - Street 1:244 CALHOUN ST APT C
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29401-1308
Practice Address - Country:US
Practice Address - Phone:336-239-0752
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-28
Last Update Date:2018-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5448235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist