Individual
MICHAEL KENNEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
1465 S GRAND BLVD, SAINT LOUIS, MO 63104-1003
(314) 577-5667
Mailing address
1465 S GRAND BLVD, SAINT LOUIS, MO 63104-1003
(314) 577-5667
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
01353
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
493318406
—
MO
Enumeration date
05/26/2006
Last updated
11/09/2020
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