Individual
SHAWNNA KENNEDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
13220 BRETON RIDGE ST, HOUSTON, TX 77070-5809
(832) 912-4773
Mailing address
11915 COTTONWOOD LN, CYPRESS, TX 77429-2771
(281) 210-7882
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2096376
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2096376
PHYSICAL THERAPIST ASSISTANT- REGULAR LICENSE
TX
Enumeration date
08/28/2018
Last updated
08/28/2018
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