Individual
CASSIE KENNEDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12628 HOOPER RD STE C, BATON ROUGE, LA 70818-3527
(225) 953-8170
Mailing address
12628 HOOPER RD STE C, BATON ROUGE, LA 70818-3527
(225) 953-8170
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
17100000X
—
LA
Enumeration date
06/22/2021
Last updated
06/22/2021
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