| Doctor Name: | DANIEL KENNEDY |
| NPI Number: | 1073747507 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PSYD |
| License Number: | 37PC00376400 |
| Business Practice Address: | 65 Meadows Dr Glassboro, NJ - 080282424 |
| Business Phone Number: | 6099700640 |
| Business Fax Number: | |
| Mailing Address: | 65 Meadows Dr, GLASSBORO |
| State: | NJ |
| Postal Code: | 080282424 |
| Phone Number: | 6099700640 |
| Fax Number: | |
| NPI Enumeration Date: | 05/12/2009 |
| NPI Last Update Date: | 04/21/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 37PC00376400 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NJ |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |