Roach, Kendall L.

Roach, Kendall L. is an sole proprietor health care provider with primary practice located at 1300 E Bradford Pkwy , Springfield MO 65804-4264. She recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as her primary health care specialty. Roach, Kendall L. can be contacted via phone (417) 761-5000.

Contact Information

Primary practice address
1300 E Bradford Pkwy Springfield MO 65804-4264
Phone: (417) 761-5000
Fax: (417) 761-5065
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X 2006026894 Missouri

Profile Details

NPI number 1104029321
LBN Legal business name Roach, Kendall L.
Credentials MA, LPC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 6th, 2007
Last updated Nov 22nd, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104029321 NPPES
Missouri MEDICAID 490117009
Missouri Other 11871325

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