| Doctor Name: | DR. RICHARD T. KENNEDY |
| NPI Number: | 1245255785 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PSY.D. |
| License Number: | PY00001919 |
| Business Practice Address: | 57 W Main St Chehalis, WA - 985324815 |
| Business Phone Number: | 3607408533 |
| Business Fax Number: | 3607408534 |
| Mailing Address: | 57 W Main St, CHEHALIS |
| State: | WA |
| Postal Code: | 985324815 |
| Phone Number: | 3607408533 |
| Fax Number: | 3607408534 |
| NPI Enumeration Date: | 07/13/2006 |
| NPI Last Update Date: | 01/07/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | PY00001919 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |