Andrew Kennedy
Behavior Technician in Imperial, CA. Individual provider (NPI-1).
NPI number1982256491
StatusActive
Last updated in NPPESJul 15, 2019
Details
- NPI
- 1982256491
- Entity type
- Individual (NPI-1)
- Name
- Andrew Kennedy
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jul 15, 2019
- Last updated
- Jul 15, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | – | – | Yes |
Practice location
148 W Sampson StImperial, CA 92251-8828
Phone 949-338-7475
Mailing address
11650 Iberia Pl Ste 130San Diego, CA 92128-2431
Phone 858-264-5858
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