Doctor Name: | MS. ANNE MARIE KENNEDY |
NPI Number: | 1023123577 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | L.I.C.S.W |
License Number: | 1026025 |
Business Practice Address: | 151 Mystic Ave Medford, MA - 021554632 |
Business Phone Number: | 7813961199 |
Business Fax Number: | 7813961439 |
Mailing Address: | 76 Wilson Rd, NAHANT |
State: | MA |
Postal Code: | 019081038 |
Phone Number: | 7815815479 |
Fax Number: | |
NPI Enumeration Date: | 08/21/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 1026025 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |