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Individual

KENNY R CARRERA I

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
2601 WILLARD RD STE 105, RICHMOND, VA 23294-3638
(804) 261-0696
Mailing address
900 N 38TH ST, RICHMOND, VA 23223-7616
(703) 655-9600

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary

Other

Enumeration date
10/18/2022
Last updated
11/10/2022
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