Individual
DR. WILLIAM DOUGLAS KENNEDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
1550 W MAIN ST, WILMINGTON, OH 45177-1031
(937) 902-8857
(937) 383-0156
Mailing address
PO BOX 944, WILMINGTON, OH 45177-0944
(937) 383-3565
(937) 383-0156
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
5171
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2005341
—
OH
Enumeration date
01/03/2007
Last updated
07/02/2020
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