Individual
JACQUELINE TAYLOR KENNEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
77 HERRICK ST STE 102, BEVERLY, MA 01915-2734
(978) 338-4321
(978) 927-1010
Mailing address
77 HERRICK ST STE 102, BEVERLY, MA 01915-2734
(978) 338-4321
(978) 927-1010
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
OPT5618
MA
152WP0200X
Pediatric Optometrist
Primary
OPT5618
MA
390200000X
Student in an Organized Health Care Education/Training Program
—
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Other
Enumeration date
05/15/2023
Last updated
08/12/2024
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