Provider Demographics
NPI:1164296547
Name:HALMAN, KENNEDY (OTR)
Entity Type:Individual
Prefix:
First Name:KENNEDY
Middle Name:
Last Name:HALMAN
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:KENNEDY
Other - Middle Name:T
Other - Last Name:RODRIGUES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OTR
Mailing Address - Street 1:3784 FAIRWAY PARK DR APT 207
Mailing Address - Street 2:
Mailing Address - City:COPLEY
Mailing Address - State:OH
Mailing Address - Zip Code:44321-2979
Mailing Address - Country:US
Mailing Address - Phone:330-861-9416
Mailing Address - Fax:
Practice Address - Street 1:16363 PEARL RD
Practice Address - Street 2:
Practice Address - City:STRONGSVILLE
Practice Address - State:OH
Practice Address - Zip Code:44136-6002
Practice Address - Country:US
Practice Address - Phone:440-316-2416
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-07
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOT012713225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist