Provider Demographics
NPI:1477817633
Name:KENNEY, SIOBHAN MARIE (MSED)
Entity Type:Individual
Prefix:MRS
First Name:SIOBHAN
Middle Name:MARIE
Last Name:KENNEY
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 HARRINGTON ST
Mailing Address - Street 2:
Mailing Address - City:NEW PALTZ
Mailing Address - State:NY
Mailing Address - Zip Code:12561-1202
Mailing Address - Country:US
Mailing Address - Phone:845-489-6129
Mailing Address - Fax:
Practice Address - Street 1:7 HARRINGTON ST
Practice Address - Street 2:
Practice Address - City:NEW PALTZ
Practice Address - State:NY
Practice Address - Zip Code:12561-1202
Practice Address - Country:US
Practice Address - Phone:845-489-6129
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-02
Last Update Date:2012-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY558418941174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist