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Individual
MS. KENNA RUTH POMEROY
Active
Individual
MS. KENNA RUTH POMEROY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CAPSW, CADC-D
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
14804-13L
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14804-13L
CADC-D
WI
05
—
39176500
—
WI
Enumeration date
04/25/2007
Last updated
07/09/2007
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