Provider Demographics
NPI:1417656786
Name:SPRING, KENNEDY RAYNE
Entity Type:Individual
Prefix:
First Name:KENNEDY
Middle Name:RAYNE
Last Name:SPRING
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:KENNEDY
Other - Middle Name:RAYNE
Other - Last Name:MCCAUSLAND
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5328 STORM KING
Mailing Address - Street 2:
Mailing Address - City:SCHERTZ
Mailing Address - State:TX
Mailing Address - Zip Code:78108-2026
Mailing Address - Country:US
Mailing Address - Phone:605-593-3444
Mailing Address - Fax:
Practice Address - Street 1:933 FM 3009
Practice Address - Street 2:
Practice Address - City:SCHERTZ
Practice Address - State:TX
Practice Address - Zip Code:78154-1000
Practice Address - Country:US
Practice Address - Phone:830-645-9800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-27
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst