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Individual
KENDRA ELISE O'BERRY
Active
Individual
KENDRA ELISE O'BERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LISW
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
NULL
1041C0700X
Clinical Social Worker
Primary
CSW007182
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12108
SC LICENSURE
SC
Enumeration date
04/12/2019
Last updated
12/21/2022
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