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Individual

MISS ANGELA JEAN KENNEDY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MA-CCC/SLP

Contact information

Practice address
620 N ALLEGHANEY AVE, ODESSA, TX 79761-4408
(432) 332-8244
(432) 580-7428
Mailing address
620 N ALLEGHANEY AVE, ODESSA, TX 79761-4408
(432) 332-8244
(432) 580-7428

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
103363
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
103363
STATE LICENSE NUMBER
TX
Enumeration date
02/12/2009
Last updated
02/12/2009
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