Individual
MISS KENNESHA A. MAIR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
819 NE 26TH ST, WILTON MANORS, FL 33305-1239
(954) 390-7654
Mailing address
819 NE 26TH ST, WILTON MANORS, FL 33305-1239
(954) 390-7654
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
ISW 4357
FL
Other
Enumeration date
10/02/2012
Last updated
10/02/2012
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