Individual
DR. MARTIN GERARD KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
4142 KEATON CROSSING BLVD, SUITE 101, O FALLON, MO 63368-8404
(636) 300-9333
Mailing address
4142 KEATON CROSSING BLVD, SUITE 101, O FALLON, MO 63368-8404
(636) 300-9333
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
2011011884
MO
Other
Enumeration date
05/16/2011
Last updated
05/16/2011
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