Individual
KENNEDY FAITH WILBERT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CYPS, OCPSA
Contact information
Practice address
2115 W PARK DR, LORAIN, OH 44053-1138
(440) 989-4900
Mailing address
2115 W PARK DR, LORAIN, OH 44053-1138
(440) 989-4900
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
YPS.000014
OH
405300000X
Prevention Professional
Primary
OCPSA.161928
OH
Other
Enumeration date
09/06/2023
Last updated
09/06/2023
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