Individual
KENNARD DANIEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2759 MARTIN LUTHER KING JR AVE SE STE 301, WASHINGTON, DC 20032-2651
(301) 732-1272
Mailing address
3950 GARDEN CITY DR APT 656, HYATTSVILLE, MD 20785-2415
(404) 409-9125
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
Other
Enumeration date
04/12/2023
Last updated
05/05/2023
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