Individual
KRISTIN KENNEDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LADAC
Contact information
Practice address
6464 MONTE SERRANO NE, ALBUQUERQUE, NM 87111-1284
(505) 715-2577
Mailing address
6464 MONTE SERRANO NE, ALBUQUERQUE, NM 87111-1284
(505) 715-2577
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
0089291
NM
Other
Enumeration date
11/29/2011
Last updated
11/29/2011
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