Individual
BAILEY RENATE KENNINGTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
84 COUNTY ROAD 610, ENTERPRISE, AL 36330-5230
(334) 389-1014
Mailing address
84 COUNTY ROAD 610, ENTERPRISE, AL 36330-5230
(334) 389-1014
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
243779
—
AL
Enumeration date
07/06/2021
Last updated
07/06/2021
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