Individual
MS. CAROLYN LOUISE KENNGOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A.,CCC,SLP
Contact information
Practice address
519 BOURNE LN, VICTOR, MT 59875-9775
(406) 961-3592
Mailing address
519 BOURNE LN, VICTOR, MT 59875-9775
(406) 961-3592
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
656
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0532506
—
MT
Enumeration date
01/19/2007
Last updated
07/09/2007
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