Individual
DR. REBECCA KENNEDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
3206 ETHAN ALLEN HWY, NEW HAVEN, VT 05472-1040
(802) 782-3610
Mailing address
3206 ETHAN ALLEN HWY, NEW HAVEN, VT 05472-1040
(802) 782-3610
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
48-0000251
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11607495
CAQH
VT
05
—
VT 2598
—
VT
Enumeration date
05/18/2007
Last updated
07/08/2007
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