Individual
KATHERINE E KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CSW, MS, SAC-IT
Contact information
Practice address
9433 COUNTY RD J, MINOCQUA, WI 54548-9318
(715) 356-5377
(715) 356-5378
Mailing address
9433 COUNTY RD J, MINOCQUA, WI 54548-9318
(715) 356-5377
(715) 356-5378
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
16533-130
WI
101YP2500X
Professional Counselor
Primary
1712-226
WI
104100000X
Social Worker
9677-120
WI
Other
Enumeration date
03/07/2013
Last updated
03/29/2013
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