Individual
JESSICA KENDORSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
41 PACELLA PARK DR, RANDOLPH, MA 02368-1755
(781) 440-0400
Mailing address
1000 CRAWFORD PL, MOUNT LAUREL, NJ 08054-3932
(856) 448-5130
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103K00000X
Behavior Analyst
Primary
1-10-7326
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110026265
—
MA
Enumeration date
03/24/2011
Last updated
04/23/2020
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