Organization
KENNEDY KRIEGER ASSOCIATES, INC.
Active
Parent organization
KENNEDY KRIEGER INSTITUTE
Other names
Kennedy Krieger Institute
Organization subpart
Yes
Provider details
NPI number
Legal business name
KENNEDY KRIEGER INSTITUTE
Authorized official
MR. MIKE NEUMAN (VICE PRESIDENT FINANCE)
(443) 923-1810
Entity
Organization
Contact information
Practice address
707 N. BROADWAY, BALTIMORE, MD 21205
(443) 923-9200
(443) 923-9405
Mailing address
P.O. BOX 744865, ATLANTA, GA 30374
(443) 923-1886
(443) 923-1895
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
30036
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
414602600
—
MD
Enumeration date
06/23/2008
Last updated
09/16/2020
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