Individual
DR. LINDA T KENNEDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
509 11TH ST, SUITE A, LAS VEGAS, NM 87701-3958
(505) 425-3155
(505) 425-3155
Mailing address
PO BOX 236, LAS VEGAS, NM 87701-0236
(505) 425-3155
(505) 425-3155
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0861
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
76071235
—
NM
Enumeration date
08/31/2006
Last updated
03/31/2011
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