Individual
MRS. BRIDGET ROSE KENNEDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
3320 S LOOP 256, PALESTINE, TX 75801-6984
(903) 723-6136
(903) 589-3443
Mailing address
PO BOX 3668, PALESTINE, TX 75802-3668
(903) 512-0486
(903) 589-3443
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
99348
TX
101YM0800X
Mental Health Counselor
Primary
70364
TX
Other
Enumeration date
05/12/2015
Last updated
05/12/2015
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