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NPI Code Detail

MEDICARE: EMILY KENNEDY M.ED.

MEDICARE: EMILY KENNEDY M.ED.
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
1235Z00000XSpeech-Language PathologistPCET002072GA
2235Z00000XSpeech-Language PathologistSLP008882GA

General Provider Information

NPI Number : 1508265919
Entity Type Code : Individual
Provider Name (Legal Business Name) : EMILY KENNEDY M.ED.
Provider Business Mailing Address
First Line : 6505 SHILOH RD STE 100
Second Line :
City : ALPHARETTA
State : GA
Zip : 30005-1645
Country : US
Telephone Number : 678-648-7644
Fax Number : 678-882-7040
Provider Business Practice Location Address
First Line : 3330 CHASTAIN MEADOWS PKWY NW # 200
Second Line :
City : KENNESAW
State : GA
Zip : 30144-5881
Country : US
Telephone Number : 678-648-7644
Fax Number : 678-882-7040
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/21/2014
Last Update Date : 11/13/2024

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Directions to “ EMILY KENNEDY M.ED.” Practice Location

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