Individual
MRS. AUDREY ANN KENGLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.,CCC-SLP
Contact information
Practice address
420 N MAIN ST, GREENWOOD, AR 72936-7007
(479) 996-4142
Mailing address
PO BOX 834, CHARLESTON, AR 72933-0834
(479) 965-1424
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2262
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
159480721
—
AR
Enumeration date
09/05/2008
Last updated
09/05/2008
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