Provider Demographics
NPI:1134303266
Name:KENNEDY DONOVAN
Entity Type:Organization
Organization Name:KENNEDY DONOVAN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DEVELOPMENTAL SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:PAMELA HOOD
Authorized Official - Middle Name:A
Authorized Official - Last Name:HOOD
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:508-997-1570
Mailing Address - Street 1:183 HILLSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:MA
Mailing Address - Zip Code:02726-2646
Mailing Address - Country:US
Mailing Address - Phone:774-644-6648
Mailing Address - Fax:
Practice Address - Street 1:389 COUNTY ST
Practice Address - Street 2:
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02740-4995
Practice Address - Country:US
Practice Address - Phone:508-997-1570
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAX252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency