Individual
MR. ROGER KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1652 NW HUGHWOOD CT, ROSEBURG, OR 97471-8844
(541) 673-3985
Mailing address
1652 NW HUGHWOOD CT, ROSEBURG, OR 97471-8844
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YP2500X
Professional Counselor
Primary
C7069
OR
Other
Enumeration date
07/22/2020
Last updated
04/04/2023
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