Individual
ELIZABETH ANN KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
2211 LOMAS BLVD NE, ALBUQUERQUE, NM 87106-2719
(505) 476-4940
Mailing address
9200 E 30TH ST, TUCSON, AZ 85710-8004
(520) 861-2089
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
61335296
WA
224Z00000X
Occupational Therapy Assistant
OC.61335296
WA
224Z00000X
Occupational Therapy Assistant
Primary
OTA-006410
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OTA-006410
AZ BOARD OF OCCUPATIONAL THERAPY
AZ
Enumeration date
07/25/2022
Last updated
08/08/2022
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