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NPI Code Detail

MEDICARE: JOSEPH KENNELL PHD

MEDICARE: JOSEPH KENNELL PHD
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
1103T00000XPsychologist557WV

General Provider Information

NPI Number : 1649305988
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOSEPH KENNELL PHD
Provider Business Mailing Address
First Line : 3705 EMERSON AVE
Second Line :
City : PARKERSBURG
State : WV
Zip : 26104-1118
Country : US
Telephone Number : 304-865-0272
Fax Number : 304-865-0265
Provider Business Practice Location Address
First Line : 3705 EMERSON AVE
Second Line :
City : PARKERSBURG
State : WV
Zip : 26104-1118
Country : US
Telephone Number : 304-865-0272
Fax Number : 304-865-0265
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/23/2007
Last Update Date : 12/09/2016

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Directions to “ JOSEPH KENNELL PHD” Practice Location

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