Individual
MRS. STACIE DAWN KENNARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
2125 ROYCE ST, PORTSMOUTH, OH 45662-4714
(740) 876-9232
(740) 876-9525
Mailing address
825 DORRENE DR, WHEELERSBURG, OH 45694-1824
(740) 574-2436
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT-6494
OH
Other
Enumeration date
09/16/2006
Last updated
07/29/2009
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