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General NPI Number Information
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NPI Number | 1932061538
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Entity Type | Individual
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Provider Name | KYNSI KENNISON
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Gender | Female
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Dates
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Enumeration Date | 12/02/2025
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Last Update Date | 12/02/2025
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Provider Practice Location Address
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Address Line | 782 FOXRIDGE CENTER DR
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City | ORANGE PARK
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State | FL
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Zip | 32065-5776
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Country | US
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Telephone | 904-637-1400
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Fax |
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Provider Business Mailing Address
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Address Line | 1634 LIBERTY TREE PL
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City | JACKSONVILLE
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State | FL
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Zip | 32221-1984
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Country | US
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Telephone | 904-437-2009
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State | FL
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