Individual
DR. KYLE JOSEPH JENNETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
071.010665
IL
103T00000X
Psychologist
071.010665
IL
103TC0700X
Clinical Psychologist
Primary
071.010665
IL
Other
Enumeration date
03/31/2022
Last updated
05/27/2024
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