Individual
KAITLIN LEEANNE PENNINGTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
9415 N KENWOOD AVE, INDIANAPOLIS, IN 46260-1442
(219) 218-0782
Mailing address
9415 N KENWOOD AVE, INDIANAPOLIS, IN 46260-1442
(219) 218-0782
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
22005854A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300088445
—
IN
Enumeration date
10/14/2014
Last updated
06/30/2025
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