Individual
KENNY M MASCARY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
504 DUDLEY ST, ROXBURY, MA 02119-2732
(857) 277-8342
Mailing address
504 DUDLEY ST, ROXBURY, MA 02119-2732
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
09/09/2021
Last updated
09/09/2021
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