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Individual

MS. KIMBERLY ANN KERNEHAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS-CAT, CASAC

Contact information

Practice address
4 FULLER ST, ALEXANDRIA BAY, NY 13607-1316
(315) 482-1290
Mailing address
164 DENNISON RD, MASSENA, NY 13662-3223
(315) 482-1290

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
32047
NY

Other

Enumeration date
03/15/2016
Last updated
03/15/2016
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