| NPI | 1255665030 |
|---|---|
| Former Name | BRIAN ERIC KENNEDY |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: NY 011500) |
| Additional Taxonomies | 101YP2500X Counselor Professional |
| Enumeration Date | 2009-09-25 |
| Last Update Date | 2023-10-04 |