Individual
ROBERT W KENNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
106 TUCKER ST, JACKSON, TN 38301-4035
(731) 427-1740
(731) 427-1436
Mailing address
106 TUCKER ST, JACKSON, TN 38301-4035
(731) 427-1740
(731) 427-1436
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
P0000001493
TN
103TF0200X
Forensic Psychologist
Primary
P0000001493
TN
Other
Enumeration date
01/31/2007
Last updated
12/09/2010
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