Individual
JEANETTE ANN KENNEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LADC
Contact information
Practice address
567 VAUXHALL STREET EXT, WATERFORD, CT 06385-4330
(860) 608-3404
(860) 889-2876
Mailing address
44 OTIS ST, NORWICH, CT 06360-4420
(860) 608-3404
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
001263
CT
Other
Enumeration date
05/16/2020
Last updated
06/01/2020
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