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1316548704
DEREK MICHAEL KENNEDY
CLINTON, IA
NPI
1316548704
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2020-11-03
Last Update Date
2020-11-03
Business Address
DEREK MICHAEL KENNEDY BA
250 20TH AVE N
CLINTON, IA 52732-2503
Phone number: 563-243-2124
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Mailing Address
DEREK MICHAEL KENNEDY BA
250 20TH AVE N
CLINTON, IA 52732-2503
Phone number: 563-243-2124
Copy
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