Individual
MRS. LISA A KENNEDY
Active
Individual
MRS. LISA A KENNEDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
2461-C
AR
1041C0700X
Clinical Social Worker
Primary
2461-C
AR
106H00000X
Marriage & Family Therapist
2461-C
AR
Other
Enumeration date
11/16/2010
Last updated
07/19/2022
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