Individual
FAYE REBECCA KENNELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC, ATR
Contact information
Practice address
2511 E 6TH ST STE B, AUSTIN, TX 78702-0047
(401) 529-8194
(401) 529-8194
Mailing address
1209 GARDEN ST, AUSTIN, TX 78702-5322
(401) 529-8194
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
75684
TX
Other
Enumeration date
01/23/2018
Last updated
01/23/2018
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