Individual
KENNESSE DEW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10611 NW SR 20, BRISTOL, FL 32321
(850) 643-1033
(850) 643-5066
Mailing address
6314 BIRCHWOOD RD, MARIANNA, FL 32448-5202
(850) 272-5764
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
ISW13452
FL
Other
Enumeration date
09/12/2019
Last updated
09/12/2019
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