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Individual
KERRI KIDWELL
Active
Individual
KERRI KIDWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SUDRC #11205
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
11205
CA
Other
Enumeration date
06/14/2021
Last updated
06/14/2021
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