Provider Demographics
NPI:1760683411
Name:KEMP, MALINDA K (MA CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:MALINDA
Middle Name:K
Last Name:KEMP
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:365 BONAVENTURE DR
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:NC
Mailing Address - Zip Code:28147-6813
Mailing Address - Country:US
Mailing Address - Phone:704-636-9551
Mailing Address - Fax:
Practice Address - Street 1:365 BONAVENTURE DR
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:NC
Practice Address - Zip Code:28147-6813
Practice Address - Country:US
Practice Address - Phone:704-636-9551
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4667235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist