| Doctor Name: | MRS. KATHERINE ROSE KENNEDY BARRY |
| NPI Number: | 1083964381 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MA |
| License Number: | 178.008171 |
| Business Practice Address: | 3504 Commercial Ave Northbrook, IL - 600621821 |
| Business Phone Number: | 8472725111 |
| Business Fax Number: | |
| Mailing Address: | 1104 W Montana St, 2 CHICAGO |
| State: | IL |
| Postal Code: | 606142221 |
| Phone Number: | 6082952830 |
| Fax Number: | |
| NPI Enumeration Date: | 09/13/2012 |
| NPI Last Update Date: | 05/12/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 178.008171 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |