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General NPI Number Information
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NPI Number | 1760749766
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Entity Type | Organization
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Legal Business Name | KENNEDY THERAPY SERVICES
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Dates
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Enumeration Date | 04/13/2012
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Last Update Date | 12/09/2025
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Provider Practice Location Address
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Address Line | 3839 HIGHWAY 42
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City | CHERRY VALLEY
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State | AR
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Zip | 72324-8849
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Country | US
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Telephone | 901-626-1587
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Fax |
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Provider Business Mailing Address
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Address Line | 3839 HIGHWAY 42
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City | CHERRY VALLEY
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State | AR
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Zip | 72324-8849
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Country | US
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Telephone | 901-626-1587
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. MISTY M KENNEDY
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Credential | OTR/L
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Telephone | 901-626-1587
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OTR1443
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License Number State | AR
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