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General NPI Number Information
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NPI Number | 1982531851
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Entity Type | Individual
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Provider Name | MR. DAJUAN PIERRE KENNEDY
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Gender | Male
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Dates
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Enumeration Date | 05/06/2026
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Last Update Date | 05/06/2026
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Provider Practice Location Address
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Address Line | 3035 S MARYLAND PKWY
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City | LAS VEGAS
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State | NV
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Zip | 89109-2200
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Country | US
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Telephone | 702-786-0460
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Fax | 702-982-7964
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Provider Business Mailing Address
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Address Line | 510 COLLEGE DR APT 1023
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City | HENDERSON
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State | NV
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Zip | 89015-1533
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Country | US
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Telephone | 702-588-0827
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State | NV
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