Provider Demographics
NPI:1679622617
Name:KENNEY, VERONICA (MS, CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:VERONICA
Middle Name:
Last Name:KENNEY
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 COLUMBINE CT
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59802-3325
Mailing Address - Country:US
Mailing Address - Phone:406-546-8029
Mailing Address - Fax:
Practice Address - Street 1:23 COLUMBINE CT
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59802-3325
Practice Address - Country:US
Practice Address - Phone:406-546-8029
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1039235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist