Organization
KENNETZ KIDS OT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIRIAM PENAFLOR KENNETZ (OCCUPATIONAL THERAPIST)
(901) 687-8233
Entity
Organization
Contact information
Practice address
5067 FARMLAND WAY, BARTLETT, TN 38002-2510
(901) 687-8233
Mailing address
5067 FARMLAND WAY, BARTLETT, TN 38002-2510
(901) 687-8233
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
—
—
Other
Enumeration date
10/07/2024
Last updated
10/07/2024
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