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Individual

DR. MARY E. KENNINGTON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PH.D.

Contact information

Practice address
10611 GRANT ROAD, HOUSTON, TX 77070
(713) 201-8791
(281) 370-6521
Mailing address
11911 CYPRESSWOOD DRIVE, HOUSTON, TX 77070
(713) 201-8791
(281) 370-6521

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
25490
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00000030KP
BLUE CROSS NUMBER
TX
01
247605
COMPPSYCH PROVIDER NUMBER
TX
01
2596763
CONCENTRA NUMBER
TX
01
3099690
AETNA PROVIDER NUMBER
TX
Enumeration date
10/03/2006
Last updated
07/08/2007
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