Individual
KEZIA VIDA KAMENETZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
40 BISCARNER RD, LUMBERTON, MS 39455-4509
(917) 673-5807
Mailing address
40 BISCARNER RD, LUMBERTON, MS 39455-4509
(917) 673-5807
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
PLC10570
LA
Other
Enumeration date
07/18/2025
Last updated
07/18/2025
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