Individual
KENNEDY STEWARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
321 E LAKE ST STE 7, PETOSKEY, MI 49770-2459
(231) 431-0400
Mailing address
PO BOX 458, LAKE ODESSA, MI 48849-0458
(616) 889-0173
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6451022272
MI
Other
Enumeration date
06/30/2022
Last updated
06/30/2022
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