Individual
MR. DAVID ALLAN KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LLP
Contact information
Practice address
125 E SOUTHERN AVE, MUSKEGON, MI 49442-5041
(231) 724-3699
(231) 724-3659
Mailing address
3260 DAVIS RD, MUSKEGON, MI 49441-4170
(231) 780-1480
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6301007108
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DK007108
BCBS PIN
MI
Enumeration date
04/25/2007
Last updated
07/08/2007
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