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Individual

AMANDA R GROVE-KENNEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
AU.D.

Contact information

Practice address
980 W STATE ST., SALEM, OH 44460
(330) 726-3339
(330) 726-0482
Mailing address
1032 BOARDMAN CANFIELD RD, #102, YOUNGSTOWN, OH 44512
(330) 726-3339
(330) 726-0482

Taxonomy

Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
A01571
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000487075
ANTHEM
OH
01
000000503366
ANTHEM
OH
05
2097985
OH
Enumeration date
08/01/2006
Last updated
01/27/2010
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