Kennedy Rose

NPI #1770936270 in Shawnee, Oklahoma

Provider Information

NPI Number: 1770936270
Entity Type: Individual
Name: Kennedy Rose
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Peer Specialist
Enumeration Date: Jul 20, 2016
Last Updated: Jul 20, 2016

Practice Location

Address: 1010 E 45TH ST
City: Shawnee
State: Oklahoma
ZIP Code: 74804-2202
Phone: (405) 273-1170

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Peer Specialist	175T00000X	Primary

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