| NPI | 1700972320 |
|---|---|
| Former Name | ANGELA ANN KENNEDY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MN LP4330) |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MN LP4330) |
| 103TF0200X Psychologist, Forensic (Licence: MN LP4330) | |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: MN LP4330) | |
| 103TP2701X Psychologist, Group Psychotherapy (Licence: MN LP4330) | |
| 103TC0700X Psychologist, Clinical (Licence: MN LP4330) | |
| 103TC1900X Psychologist, Counseling (Licence: MN LP4330) | |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2023-08-18 |