Provider Demographics
NPI:1053935577
Name:LENTNER, KATHRYN MARIE
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:MARIE
Last Name:LENTNER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10424 29TH ST S
Mailing Address - Street 2:
Mailing Address - City:SCOTTS
Mailing Address - State:MI
Mailing Address - Zip Code:49088-9743
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8089 STADIUM DR
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49009-6270
Practice Address - Country:US
Practice Address - Phone:269-281-9091
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-01
Last Update Date:2020-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI3501010599237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist