(800) 868-1923

Most Relevant Information


Provider Data
NPI Number: 1003474784
Provider Name: KELLY KENNEDY
Entity Type: Individual
Taxonomy Code: 101YM0800X
Specialty: Counselor
License Number:
Most Important Dates
Enumeration Date: 05/29/2019
Last Updated: 06/20/2024
Provider Practice Location
236 MOULTRIE PL
SANTA PAULA
CA
930603241
Practice Location Phone/Fax
Phone: 8058508632
Fax: 8055660298
Provider Mailing Location
236 MOULTRIE PL
SANTA PAULA
CA
930603241
Provider Mailing Phone/Fax
Phone: 8058508632
Fax: 8055660298