Provider Demographics
NPI:1902522022
Name:KENNEDY, ALLYSON MARIE (MS, CF-SLP)
Entity Type:Individual
Prefix:
First Name:ALLYSON
Middle Name:MARIE
Last Name:KENNEDY
Suffix:
Gender:F
Credentials:MS, CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:91 REID AVE
Mailing Address - Street 2:
Mailing Address - City:ROCKAWAY POINT
Mailing Address - State:NY
Mailing Address - Zip Code:11697-1202
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1070 E 104TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11236-4526
Practice Address - Country:US
Practice Address - Phone:718-444-4316
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-19
Last Update Date:2022-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist