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General NPI Number Information
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NPI Number | 1164461216
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Entity Type | Individual
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Provider Name | DAPHNE KENDRICKS PH.D.
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Gender | Female
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Dates
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Enumeration Date | 06/05/2006
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Last Update Date | 01/12/2023
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Provider Practice Location Address
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Address Line | 3224 N COLLEGE RD # C-124
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City | WILMINGTON
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State | NC
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Zip | 28405-8826
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Country | US
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Telephone | 619-323-9459
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Fax |
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Provider Business Mailing Address
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Address Line | 3224 N COLLEGE RD # C-124
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City | WILMINGTON
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State | NC
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Zip | 28405-8826
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Country | US
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Telephone | 619-323-9459
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY-TL-0400
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 2734
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License Number State | NC
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