Individual
MISS KARA BREANNE KENNEDY I
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
456 SAM THOMAS RD, HARVEST, AL 35749-9073
(256) 665-5807
Mailing address
456 SAM THOMAS RD, HARVEST, AL 35749-9073
(256) 665-5807
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
8709761
AL
Other
Enumeration date
01/02/2017
Last updated
01/02/2017
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