| NPI | 1629850581 |
|---|---|
| Former Name | KODA KENNEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2023-10-16 |
| Last Update Date | 2026-09-18 |