Individual
DR. SEAN J KENNY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
233 FULTON ST E, SUITE 428, GRAND RAPIDS, MI 49503-3200
(616) 752-8381
Mailing address
233 FULTON ST E, SUITE 428, GRAND RAPIDS, MI 49503-3200
(616) 752-8381
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
6301009458
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
68-0-D1-4643-0
BLUE CROSS PROVIDER ID
MI
Enumeration date
07/31/2006
Last updated
07/08/2007
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