Individual
SHANNON KENNY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
800 STONE CREEK PKWY STE 7, LOUISVILLE, KY 40223-5366
(502) 915-8343
Mailing address
800 STONE CREEK PKWY STE 7, LOUISVILLE, KY 40223-5366
(502) 915-8343
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
260285
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
260285
—
KY
Enumeration date
06/03/2020
Last updated
06/03/2020
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