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Individual

DR. RICHARD G KENNEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
2901 OHIO BLVD, SUITE 202, TERRE HAUTE, IN 47803-2239
(812) 232-2144
(812) 234-4598
Mailing address
2901 OHIO BLVD, SUITE 202, TERRE HAUTE, IN 47803-2239
(812) 232-2144
(812) 234-4598

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
20041262A
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200192280
IN
Enumeration date
07/19/2005
Last updated
06/26/2014
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