Provider / Organization | NPI | Date Certified |
---|---|---|
PHILLIP KENNEDY | 1235844218 | 2023-01-13 |
Phillip Kennedy is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1235844218. Registration indicates Phillip Kennedy is a provider of services with a specialization in Behavioral Health & Social Service Providers, Behavior Technician (Behavior Technician, Behavioral Health & Social Service Providers) (Behavior Technician, )
Entity Type | Individual |
Provider Name | Phillip Kennedy |
Practice Office Address | 7810 E 108TH ST TULSA, OK US |
Practice Office Telephone | 8552237123 |
Mailing Address | 16782 VON KARMAN AVE STE 11 IRVINE, CA 926062417 US |
Business Telephone | 8552237123 |
Code | Practice | License No State |
---|---|---|
106S00000X PRIMARY | Behavioral Health & Social Service Providers Behavior Technician Behavior Technician Behavioral Health & Social Service Providers Behavior Technician |