Individual
CHARLES ANDREW KENNEDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ASW
Contact information
Practice address
16387 FIRST STREET, GUERNEVILLE, CA 95446-9544
(707) 326-1452
Mailing address
PO BOX 1449, GUERNEVILLE, CA 95446-1449
(707) 326-1425
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
109436
CA
Other
Enumeration date
11/01/2022
Last updated
11/01/2022
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