Individual
ANN MARIE KENNEDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RADT-1
Contact information
Practice address
17270 ROOSEVELT ST, RIVERSIDE, CA 92508-9523
(951) 780-2541
(951) 780-5809
Mailing address
5870 ARLINGTON AVE, RIVERSIDE, CA 92504-2037
(951) 780-2541
(951) 780-5809
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
330013AN
CA
Other
Enumeration date
02/06/2017
Last updated
02/06/2017
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