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General NPI Number Information
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NPI Number | 1417656786
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Entity Type | Individual
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Provider Name | KENNEDY RAYNE SPRING
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Gender | Female
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Dates
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Enumeration Date | 02/27/2023
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Last Update Date | 02/06/2024
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Provider Practice Location Address
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Address Line | 933 FM 3009
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City | SCHERTZ
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State | TX
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Zip | 78154-1000
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Country | US
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Telephone | 830-645-9800
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Fax |
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Provider Business Mailing Address
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Address Line | 5328 STORM KING
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City | SCHERTZ
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State | TX
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Zip | 78108-2026
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Country | US
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Telephone | 605-593-3444
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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