Individual
AUDREY J KENNEDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHYSICAL THERAPIST
Contact information
Practice address
1533 MEMORIAL DR, OAKLAND, MD 21550-4338
(301) 334-1123
(301) 334-1129
Mailing address
285 THORNBERRY RD, OAKLAND, MD 21550-7000
(301) 387-2919
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
18757
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0003
FEDERAL BCBS
MD
05
—
0200278000
—
WV
01
—
4345383
AETNA
MD
01
—
54736705
CAREFIRST BCBS
MD
Enumeration date
09/21/2006
Last updated
02/28/2023
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