Individual
MRS. PATRICIA L KENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
556 S BUXTON LN, REPUBLIC, MO 65738-1810
(417) 234-9174
Mailing address
556 S BUXTON LN, REPUBLIC, MO 65738-1810
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
2001017780
MO
Other
Enumeration date
08/05/2011
Last updated
08/05/2011
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