Provider Demographics
NPI:1902205560
Name:CARR-KENNEDY, AMBER
Entity Type:Individual
Prefix:MS
First Name:AMBER
Middle Name:
Last Name:CARR-KENNEDY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214 S CHERRY ST
Mailing Address - Street 2:
Mailing Address - City:KALKASKA
Mailing Address - State:MI
Mailing Address - Zip Code:49646-7903
Mailing Address - Country:US
Mailing Address - Phone:231-832-3281
Mailing Address - Fax:
Practice Address - Street 1:214 S CHERRY ST
Practice Address - Street 2:
Practice Address - City:KALKASKA
Practice Address - State:MI
Practice Address - Zip Code:49646-7903
Practice Address - Country:US
Practice Address - Phone:231-564-2516
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-20
Last Update Date:2014-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker