Individual
MAXWELL B KENNEDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MFT
Contact information
Practice address
106 OAK ST STE A, STATESBORO, GA 30458-0988
(912) 682-2709
(912) 764-5661
Mailing address
PO BOX 373, STATESBORO, GA 30459-0373
(912) 682-2709
(912) 764-5661
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
MFT000585
GA
Other
Enumeration date
08/21/2009
Last updated
08/21/2009
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