Individual
KENNY BLAKE VARNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4100 NORMAL ST, SAN DIEGO, CA 92103-2653
(619) 725-5501
Mailing address
1601 E SANDY LAKE RD, COPPELL, TX 75019-3124
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT26574
CA
Other
Enumeration date
09/24/2024
Last updated
03/23/2026
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