Individual
MRS. MARY KATHERINE KENNEDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
10727 BURR OAK WAY, BURKE, VA 22015-2414
(703) 425-9126
Mailing address
10727 BURR OAK WAY, BURKE, VA 22015-2414
(703) 425-9126
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
12/22/2011
Last updated
12/22/2011
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