Individual
MICHELE RENAE KENNEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6910 N MAIN ST UNIT 13D, GRANGER, IN 46530-9681
(269) 240-3343
Mailing address
6910 N MAIN ST UNIT 13D, GRANGER, IN 46530-9681
(269) 240-3343
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
35002274A
IN
106H00000X
Marriage & Family Therapist
85000400A
IN
Other
Enumeration date
01/18/2022
Last updated
12/31/2022
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