Individual
FREDERICA KENNEDY
Active
Individual
FREDERICA KENNEDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L, OTD
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
—
—
225X00000X
Occupational Therapist
056.006013
IL
225XP0200X
Pediatric Occupational Therapist
Primary
OT006737
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003200220A
—
GA
05
—
003200220B
—
GA
Enumeration date
05/07/2007
Last updated
03/17/2018
Update your record
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