| NPI | 1225221740 |
|---|---|
| Former Name | PRUDENCE ANNETTE KENNEDY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 81693) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2007-08-20 |
| Last Update Date | 2020-08-07 |