Individual
RICHARD C. KENNERLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
170 DAVIDSON HWY STE 201, CONCORD, NC 28027-4255
(704) 659-3541
(888) 977-3202
Mailing address
170 DAVIDSON HWY STE 106, CONCORD, NC 28027-4246
(704) 659-3541
(888) 977-3202
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
4561
NC
103G00000X
Clinical Neuropsychologist
PSY 22288
CA
103T00000X
Psychologist
4561
NC
103T00000X
Psychologist
PSY 22288
CA
103TC0700X
Clinical Psychologist
4561
NC
103TC0700X
Clinical Psychologist
PSY22288
CA
Other
Enumeration date
11/06/2008
Last updated
12/16/2019
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