Individual
SAMUEL RYAN KENNY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
321 FORTUNE BLVD, MILFORD, MA 01757-1750
(508) 478-0207
Mailing address
321 FORTUNE BLVD, MILFORD, MA 01757-1750
(508) 478-0207
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
06/10/2021
Last updated
06/23/2021
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