Individual
DAVIA KENTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAC
Contact information
Practice address
105 GROVE ST STE 5A, MONTCLAIR, NJ 07042-4053
(973) 619-9619
Mailing address
105 GROVE ST STE 5A, MONTCLAIR, NJ 07042-4053
(862) 239-6593
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
37AC00722400
NJ
Other
Enumeration date
09/21/2024
Last updated
09/21/2024
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