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Individual

MRS. MARCILYN RENEE KENNEDY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.S., CCC-SLP

Contact information

Practice address
9210 TRAIL RUN RD, SHERWOOD, AR 72120-9422
(501) 834-4100
Mailing address
9210 TRAIL RUN RD, SHERWOOD, AR 72120-9422
(501) 834-4100

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2237
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
5Y158
BLUE CROSS BLUE SHIELD
AR
Enumeration date
12/01/2006
Last updated
07/08/2007
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