Individual
MAXWELL L KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
18444 N 25TH AVE STE 420, PHOENIX, AZ 85023-1268
(602) 699-8582
Mailing address
18444 N 25TH AVE STE 420, PHOENIX, AZ 85023-1268
(602) 699-8582
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
85-2528524
—
AZ
Enumeration date
07/30/2021
Last updated
07/30/2021
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