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NPI Code Detail

MEDICARE: KENNEDY REEDER

MEDICARE: KENNEDY REEDER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family TherapistTX

General Provider Information

NPI Number : 1083573174
Entity Type Code : Individual
Provider Name (Legal Business Name) : KENNEDY REEDER
Provider Business Mailing Address
First Line : 4141 HORIZON NORTH PKWY APT 121
Second Line :
City : DALLAS
State : TX
Zip : 75287-2826
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 15851 DALLAS PKWY STE 600
Second Line :
City : ADDISON
State : TX
Zip : 75001-6030
Country : US
Telephone Number : 214-785-0147
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/15/2026
Last Update Date : 01/15/2026

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Directions to “ KENNEDY REEDER ” Practice Location

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