| NPI | 1811521099 |
|---|---|
| Former Name | HEATHER L KENNEDY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: TX 77742) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: TX 42129) |
| Enumeration Date | 2020-02-26 |
| Last Update Date | 2022-06-17 |