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Individual

LYNN A. KENNEDY-BAXTER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMFT

Contact information

Practice address
2790 N ACADEMY BLVD, SUITE 206, COLORADO SPRINGS, CO 80917-5337
(719) 534-3104
Mailing address
2130 PROFESSIONAL DR STE 240, ROSEVILLE, CA 95661-3780
(719) 534-3104

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
16946
CA
106H00000X
Marriage & Family Therapist
939
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
77-0213449
TAX ID
CA
Enumeration date
05/18/2007
Last updated
09/29/2019
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