Individual
FELICIA KENNEDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
114 N MAIN ST, SUFFOLK, VA 23434-4564
(757) 809-5376
Mailing address
112 CARRIAGE HOUSE DR, SUFFOLK, VA 23434-9219
(757) 775-0540
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
0710103035
VA
101YP2500X
Professional Counselor
Primary
0701006646
VA
Other
Enumeration date
06/10/2016
Last updated
06/10/2016
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