Provider Demographics
NPI:1851904866
Name:KENNES, ASHLEY (MS, CGC)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:KENNES
Suffix:
Gender:F
Credentials:MS, CGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 HANCOCK ST APT 2
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04101-4257
Mailing Address - Country:US
Mailing Address - Phone:339-225-5585
Mailing Address - Fax:
Practice Address - Street 1:100 CAMPUS DR UNIT 121
Practice Address - Street 2:
Practice Address - City:SCARBOROUGH
Practice Address - State:ME
Practice Address - Zip Code:04074-7172
Practice Address - Country:US
Practice Address - Phone:207-396-7788
Practice Address - Fax:207-396-8500
Is Sole Proprietor?:No
Enumeration Date:2020-08-28
Last Update Date:2020-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS