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General NPI Number Information
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NPI Number | 1447499223
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Entity Type | Individual
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Provider Name | REBECCA KENNEDY PH.D.
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Gender | Female
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Dates
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Enumeration Date | 02/18/2009
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Last Update Date | 02/14/2019
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Provider Practice Location Address
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Address Line | 310 E GOVERNMENT ST STE C-2
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City | PENSACOLA
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State | FL
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Zip | 32502-6508
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Country | US
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Telephone | 850-261-5216
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Fax |
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Provider Business Mailing Address
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Address Line | 310 E GOVERNMENT ST
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City | PENSACOLA
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State | FL
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Zip | 32502-6098
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Country | US
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Telephone | 850-266-5205
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Fax | 855-716-7540
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PY6291
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License Number State | FL
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