Individual
CASEY KENNINGTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
419 RACETRACK RD NW, FORT WALTON BEACH, FL 32547-4612
(850) 864-2273
Mailing address
419 RACETRACK RD NW, FORT WALTON BEACH, FL 32547-4612
(850) 864-2273
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
12/03/2015
Last updated
12/03/2015
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