Individual
CASEY JO KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT-17-46255
Contact information
Practice address
2715 INDUSTRIAL ST, JUNCTION CITY, KS 66441-8398
(785) 256-9096
Mailing address
11447 J HILL RD, JUNCTION CITY, KS 66441-7899
(402) 460-0010
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-17-46255
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RBT-17-46255
TRICARE
KS
Enumeration date
12/20/2017
Last updated
12/20/2017
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