| NPI | 1780090399 |
|---|---|
| Former Name | MARTIA KENNEDY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| Enumeration Date | 2014-07-02 |
| Last Update Date | 2024-05-20 |