Doctor Name: | SHALENE ANN KENNEDY |
NPI Number: | 1043295876 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MD |
License Number: | 38890 |
Business Practice Address: | 7616 Currell Blvd Suite 275 Woodbury, MN - 55125 |
Business Phone Number: | 6512640260 |
Business Fax Number: | 6512640261 |
Mailing Address: | 7616 Currell Blvd, Suite 275 WOODBURY |
State: | MN |
Postal Code: | 55125 |
Phone Number: | 6512640260 |
Fax Number: | 6512640261 |
NPI Enumeration Date: | 12/14/2005 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2084P0804X |
License Number: | 38890 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MN |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Psychiatry & Neurology |
Taxonomy Specialization: | Child & Adolescent Psychiatry |
Taxonomy Definition: | Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. |