Most Relevant Information
Provider Data
| NPI Number: | 1003582081 |
| Provider Name: | KRISTINA KENNEDY |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 08/19/2021 |
| Last Updated: | 08/19/2021 |
Provider Practice Location
1401 E 7TH ST
CHARLOTTE
NC
282046300
Practice Location Phone/Fax
| Phone: | 7047804271 |
| Fax: |
Provider Mailing Location
PO BOX 8544
PASADENA
CA
911098602
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |