Provider Demographics
NPI:1144585845
Name:KENNEDY, YOLANDA (MA)
Entity Type:Individual
Prefix:MRS
First Name:YOLANDA
Middle Name:
Last Name:KENNEDY
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2148 REMINGTON POINTE BLVD
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34743-3623
Mailing Address - Country:US
Mailing Address - Phone:407-414-6451
Mailing Address - Fax:
Practice Address - Street 1:3400 HUNTERS CREEK BLVD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32837-7230
Practice Address - Country:US
Practice Address - Phone:407-415-2493
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-09
Last Update Date:2012-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMHI9249101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health