Individual
KELLIE KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1320 UNION ST, MORRIS, IL 60450-2426
(815) 941-3404
Mailing address
1038 DUPONT AVE, MORRIS, IL 60450-1296
(815) 941-3409
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
22777
IL
Other
Enumeration date
08/26/2019
Last updated
08/26/2019
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