Individual
MIMI M KENNEDY-ROSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
DODGE & MT LEMMON RD, ORACLE, AZ 85623
(520) 896-9240
Mailing address
DODGE & MT LEMMON RD, ORACLE, AZ 85623
(520) 896-9240
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC-16413
AZ
Other
Enumeration date
01/04/2017
Last updated
01/04/2017
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