Individual
KENNIDY RAE SOUZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3493 BIGBY HOLLOW CT, COLUMBUS, OH 43228-9787
(614) 405-0463
Mailing address
4947 ARCHDALE LN, COLUMBUS, OH 43214-2317
(614) 822-9052
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
E.2404582
OH
Other
Enumeration date
08/18/2021
Last updated
08/08/2024
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