Basic Information
Provider Information
NPI: 1710010533
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KENT
FirstName: ALANA
MiddleName: ANGELINA
NamePrefix: DR.
NameSuffix:  
Credential: AU.D., CCC-A
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 6700 WASHINGTON AVE S
Address2:  
City: EDEN PRAIRIE
State: MN
PostalCode: 553443405
CountryCode: US
TelephoneNumber: 8302754216
FaxNumber: 5128582714
Practice Location
Address1: 310 N WILMOT RD STE 210
Address2:  
City: TUCSON
State: AZ
PostalCode: 85711
CountryCode: US
TelephoneNumber: 5208290600
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/13/2007
LastUpdateDate: 01/27/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 01/27/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
231H00000XDA5104AZY Speech, Language and Hearing Service ProvidersAudiologist 

No ID Information.


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