Provider Demographics
NPI:1043346802
Name:KENNEDY, RENEAU CHARLENE (EDD)
Entity Type:Individual
Prefix:DR
First Name:RENEAU
Middle Name:CHARLENE
Last Name:KENNEDY
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:133 HANAPEPE LOOP
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96825-2109
Mailing Address - Country:US
Mailing Address - Phone:808-779-4256
Mailing Address - Fax:
Practice Address - Street 1:133 HANAPEPE LOOP
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96825-2109
Practice Address - Country:US
Practice Address - Phone:808-779-4256
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2014-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7206103TF0200X
HI662103TF0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic