Individual
MICHAEL SHAWN KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
SCHOOL PSYCHOLOGIST
Contact information
Practice address
113 HAWK DR, DULCE, NM 87528
(575) 759-3225
(575) 759-3533
Mailing address
113 HAWKS DR, DULCE, NM 87528
(575) 759-3225
(575) 759-3533
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
344005
NM
Other
Enumeration date
01/11/2012
Last updated
01/11/2012
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