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Individual
KAILE RENEE PENNOCK
Active
Individual
KAILE RENEE PENNOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
OR
171M00000X
Case Manager/Care Coordinator
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
01/18/2022
Last updated
05/09/2024
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