Individual
ELIZABETH MARIE KENNEDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CCLS
Contact information
Practice address
41714 GAWTHORPE LN, LEESBURG, VA 20176-5850
(412) 979-7953
Mailing address
41714 GAWTHORPE LN, LEESBURG, VA 20176-5850
(412) 979-7953
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
24887
VA
Other
Enumeration date
07/07/2023
Last updated
07/07/2023
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