Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | PY 9042 | FL |
N | 103T00000X | Psychologist | PY 9042 | FL |
N | 103TB0200X | Cognitive & Behavioral Psychologist | PY 9042 | FL |
N | 103G00000X | Clinical Psychologist | PY 9042 | FL |
N | 103TC0700X | Clinical Psychologist | PY 9042 | FL |
N | 103TC1900X | Counseling Psychologist | PY 9042 | FL |
Y | 103TC2200X | Clinical Child & Adolescent Psychologist | PY 9042 | FL |
N | 103TF0000X | Family Psychologist | PY 9042 | FL |
NPI | 1245587831 |
---|---|
Provider Name | Dr. James R Kinney JR. |
First Address | Largo, FL 33771-3522 |
Second Address | Largo, FL 33771-3538 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/08/2012 |
Last Update Date | 26/11/2014 |