Individual
JOHN KENNEDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BCBA, LABA
Contact information
Practice address
2000 2ND AVE S APT 353, BIRMINGHAM, AL 35233-2077
(508) 971-2140
Mailing address
7108 S KANNER HWY, STUART, FL 34997-7462
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
2024-001
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110026265
—
MA
Enumeration date
11/27/2013
Last updated
01/22/2024
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