Individual
CASEY KENNY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
136 MINE LAKE CT, RALEIGH, NC 27615-6417
(919) 434-7975
Mailing address
3012 FARRIOR RD, RALEIGH, NC 27607-3725
(919) 270-4811
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
A14316
NC
Other
Enumeration date
10/01/2018
Last updated
10/01/2018
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