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Individual

AMY KENNEDY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CRC, LPC INTERN

Contact information

Practice address
1020 SW TAYLOR ST STE 366, PORTLAND, OR 97205-2508
(503) 908-5505
Mailing address
1020 SW TAYLOR ST STE 366, PORTLAND, OR 97205-2508
(503) 908-5505

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
R5448
OR

Other

Enumeration date
09/26/2018
Last updated
09/26/2018
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