Individual
ANDREA KENNEDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BS
Contact information
Practice address
2888 N THAMES AVE, MERIDIAN, ID 83646-7509
(907) 802-9193
Mailing address
1276 W RIVER ST STE 100, BOISE, ID 83702-7083
(208) 837-5474
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
ID
Other
Enumeration date
10/14/2025
Last updated
10/24/2025
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