Individual
DERIC DUANE KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2630 HOMECOMING LN, WALDORF, MD 20603-5313
(240) 412-4041
Mailing address
2630 HOMECOMING LN, WALDORF, MD 20603-5313
(240) 412-4041
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
01/22/2024
Last updated
01/22/2024
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