Individual
ELIZABETH KENNEDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
700 LIBERTY LN, WEST CARROLLTON, OH 45449-2135
(937) 247-2400
Mailing address
445 E DUBLIN GRANVILLE RD, WORTHINGTON, OH 43085-3192
(614) 844-3800
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2615030
—
OH
Enumeration date
03/07/2022
Last updated
03/07/2022
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