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NPI Code Detail

MEDICARE: MRS. YOLANDA KENNEDY M.A.

MEDICARE: MRS. YOLANDA KENNEDY M.A.
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
1101YM0800XMental Health CounselorMHI9249FL

General Provider Information

NPI Number : 1144585845
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. YOLANDA KENNEDY M.A.
Provider Business Mailing Address
First Line : 2148 REMINGTON POINTE BLVD
Second Line :
City : KISSIMMEE
State : FL
Zip : 34743-3623
Country : US
Telephone Number : 407-414-6451
Fax Number :
Provider Business Practice Location Address
First Line : 3400 HUNTERS CREEK BLVD
Second Line :
City : ORLANDO
State : FL
Zip : 32837-7230
Country : US
Telephone Number : 407-415-2493
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/09/2012
Last Update Date : 07/09/2012

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