Individual
DIANE NICOLE KENNEDY-AMOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
410 THOMAS JEFFERSON HIGHWAY, CHARLOTTE COURT HOUSE, VA 23923-0340
(434) 392-7049
(434) 392-9221
Mailing address
410 THOMAS JEFFERSON HIGHWAY, CHARLOTTE COURT HOUSE, VA 23923-0340
(434) 392-7049
(434) 392-9221
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
0701004708
VA
103TR0400X
Rehabilitation Psychologist
0812000549
VA
Other
Enumeration date
05/06/2010
Last updated
03/04/2011
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