Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist |
NPI | 1073848222 |
---|---|
Provider Name | Karen Kennedy |
First Address | South Hadley, MA 01075-1421 |
Second Address | South Hadley, MA 01075-1421 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/10/2009 |
Last Update Date | 06/10/2009 |