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Individual

KENNEDY G SANSTROM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1 HALLORAN DRIVE, ST CLAIRSVILLE, OH 43950
(740) 296-5743
(740) 296-5952
Mailing address
214 THORN AVE, MOUNDSVILLE, WV 26041-1249

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary

Other

Enumeration date
07/18/2024
Last updated
07/25/2024
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