Individual
MR. KENRICK SINCLAIR HAWTHORNE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ADVANCED CASAC
Contact information
Practice address
1064 FRANKLIN AVE, BRONX, NY 10456-6704
(718) 764-1551
(718) 764-1583
Mailing address
311 E 175TH ST, BRONX, NY 10457-5848
(718) 764-1551
(718) 764-1583
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
25248
NY
Other
Enumeration date
08/09/2019
Last updated
05/06/2020
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