Individual
MS. HEATHER JEAN HART KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW LCSW
Contact information
Practice address
817 N MARSHALL ST, MILWAUKEE, WI 53202
(414) 224-0800
(414) 224-0883
Mailing address
W9203 BLUE SPRUCE LANE, CAMBRIDGE, WI 53523
(608) 423-3960
(608) 423-7166
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6919123
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40945400
—
WI
Enumeration date
11/07/2006
Last updated
07/08/2007
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