Individual
DR. JULIA MARIE KENNEDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
3939 SAN PEDRO DR NE, ALBUQUERQUE, NM 87110-8900
(505) 379-2709
Mailing address
25 FISCHER LN, TIJERAS, NM 87059-8203
(505) 379-2709
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1084
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11703482
CAQH
NM
Enumeration date
10/17/2013
Last updated
01/26/2020
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