| Doctor Name: | MRS. KRISTINE LOUANN KENNEDY |
| NPI Number: | 1881822658 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | BA, CADC |
| License Number: | 09054 |
| Business Practice Address: | 1200 N 7th St Chariton, IA - 500491210 |
| Business Phone Number: | 6417743370 |
| Business Fax Number: | 6417743261 |
| Mailing Address: | 1200 N 7th St, CHARITON |
| State: | IA |
| Postal Code: | 500491210 |
| Phone Number: | 6417743370 |
| Fax Number: | 6417743261 |
| NPI Enumeration Date: | 06/30/2009 |
| NPI Last Update Date: | 03/31/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 09054 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |