Provider Demographics
NPI:1053152215
Name:KENARY, REID WATSON (PSYD)
Entity type:Individual
Prefix:DR
First Name:REID
Middle Name:WATSON
Last Name:KENARY
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 SOLEY ST UNIT 2
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02129-3310
Mailing Address - Country:US
Mailing Address - Phone:860-916-0438
Mailing Address - Fax:
Practice Address - Street 1:33 SOLEY ST UNIT 2
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02129-3310
Practice Address - Country:US
Practice Address - Phone:860-916-0438
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-03
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPSY10000748103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical