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Individual

SHAYE LEIGH KENNEDY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
4510 CASCADE DR, POWELL, OH 43065-9732
(614) 323-5070
Mailing address
4510 CASCADE DR, POWELL, OH 43065-9732
(614) 323-5070

Taxonomy

Speciality
Code
Description
License number
State
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2102530
OH
Enumeration date
05/01/2007
Last updated
07/09/2007
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