Individual
TAZENA KENNEDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
330 IVY ST, JACKSONVILLE, FL 32206-6350
(904) 307-6844
(904) 924-1174
Mailing address
PO BOX 2678, JACKSONVILLE, FL 32203-2678
(904) 307-6844
(904) 924-1174
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
11/28/2006
Last updated
07/09/2007
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